Aoki Tadashi, Zakoji Hidenori, Kamiyama Manabu, Yamagishi Takashi, Takahashi Nobuhiro, Ootake Yuko, Kira Satoru, Miyamoto Tatsuya, Sawada Norifumi, Takeda Masayuki
Department of Urology, Faculty of Medicine, University of Yamanashi.
Nihon Hinyokika Gakkai Zasshi. 2016;107(2):111-114. doi: 10.5980/jpnjurol.107.111.
The Hem-o-lok clips (HOLC) is frequently used for hemostasis of the lateral pedicles in robot-assisted prostatectomy (RARP) and laparoscopic radical prostatectomy (LRP). We report a rare post-operative complication, the migration of a HOLC into the bladder leading to calculus formation after RARP. A 54 year-old man underwent RARP with nerve- sparing procedure with HOLCs in the left neurovascular bundle. Three months later, he was referred to our hospital for pollakisuria and spontaneous hematuria. Abdominal ultrasonographic examination and computed tomography (CT) demonstrated a bladder stone that was 7 mm in diameter. On cystourethroscopy, he was noted to have a yellow-colored stone at 9 o'clock position of vesicourethral anastomosis. A cystolithotripsy for a bladder stone was performed until the surface of it was broken. A HOLC with a calculus was revealed and retrieved by stone forceps through the urethra. Since then, Intravesical migration of a HOLC has not been observed.
Hem-o-lok夹（HOLC）常用于机器人辅助前列腺切除术（RARP）和腹腔镜根治性前列腺切除术（LRP）中侧蒂的止血。我们报告了1例罕见的术后并发症，RARP术后HOLC迁移至膀胱导致结石形成。1例54岁男性接受保留神经的RARP，在左侧神经血管束处使用了HOLC。3个月后，因尿频和自发性血尿转诊至我院。腹部超声检查和计算机断层扫描（CT）显示直径7 mm的膀胱结石。膀胱尿道镜检查发现膀胱尿道吻合口9点位置有黄色结石。对膀胱结石进行了膀胱碎石术，直至其表面破碎。通过尿道用结石钳取出了1枚带有结石的HOLC。此后，未再观察到HOLC向膀胱内迁移。
