机器人辅助根治性前列腺切除术后盆腔假性动脉瘤致严重血尿。
Pelvic Pseudoaneurysm as a Cause of Severe Hematuria After Robotic-assisted Radical Prostatectomy.
机构信息
Division of Uro-Oncology, Department of Surgical Oncology, Beneficência Portuguesa Hospital of São Paulo, São Paulo, Brazil.
Division of Uro-Oncology, Department of Surgical Oncology, Beneficência Portuguesa Hospital of São Paulo, São Paulo, Brazil.
出版信息
Urology. 2021 Feb;148:e23-e24. doi: 10.1016/j.urology.2020.10.036. Epub 2020 Nov 6.
OBJECTIVE
To alert the medical society regarding that hematuria after radical prostatectomy can be caused by pelvic pseudoaneurysm.
METHODS
Case report of a 61-year-old male underwent extraperitoneal robotic-assisted radical prostatectomy. He was readmitted on the 15th POD due to gross hematuria with resolution after bladder irrigation. It returned on the 21st POD.
RESULTS
The CT angiography evidenced the pseudoaneurysm of the left internal iliac artery. Selective embolization was effectively performed, with no additional bleeding or pelvic ischemia. Endovascular therapy is the preferred method of treatment.
CONCLUSION
The pelvic pseudoaneurysm is a rare, but serious complication that can cause severe bleeding. In our experience, we had 3 cases of persistent hematuria caused by pelvic pseudoaneurysm after 1810 robotic-assisted radical prostatectomy.
目的
提醒医学界注意，根治性前列腺切除术后血尿可能是由骨盆假性动脉瘤引起的。
方法
报告 1 例 61 岁男性患者，行腹膜外机器人辅助根治性前列腺切除术。术后第 15 天因肉眼血尿再次入院，行膀胱冲洗后血尿缓解。第 21 天再次出现肉眼血尿。
结果
CT 血管造影显示左侧髂内动脉假性动脉瘤。选择性栓塞治疗有效，无再次出血或骨盆缺血。血管内治疗是首选的治疗方法。
结论
骨盆假性动脉瘤是一种罕见但严重的并发症，可导致严重出血。根据我们的经验，在 1810 例机器人辅助根治性前列腺切除术后，有 3 例因骨盆假性动脉瘤导致持续性血尿。
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