Dong Zhenyang, He Biming, Gao Xu, Xu Chuanliang, Sun Yinghao, Wang Haifeng
Department of Urology, Changhai Hospital, Shanghai, China.
Department of Urology, Shanghai East Hospital, Shanghai, China.
J Endourol Case Rep. 2020 Dec 29;6(4):516-518. doi: 10.1089/cren.2019.0147. eCollection 2020.
The inability to remove an indwelling urethral catheter in a postrobot-assisted laparoscopic radical prostatectomy (RALP) patient constitutes a serious problem to the urologist. If the proper deflation of the catheter balloon is not observed, forcible extraction can lead to devastating consequences such as urethral disruption and subsequent stricture formation. A 60-year-old male patient developed lower urinary-tract symptoms 20 months after robotic prostatectomy for early prostate cancer. Cystourethroscopy revealed a migrated Hemo-lok clip that was extracted near the anastomotic site, followed by insertion of an indwelling Foley catheter. Two weeks later, the patient accidentally pulled the catheter into the urethra. Several attempts were done to deflate the catheter, which failed. Subsequently, a transrectal ultrasound (TRUS)-guided transperineal puncture was done to deflate the catheter balloon followed by effective catheter removal. TRUS-guided transperineal puncture (under local anesthesia) of an indwelling catheter balloon is a viable alternative for patients who have a history of RALP.
对于接受机器人辅助腹腔镜根治性前列腺切除术（RALP）的患者，无法拔除留置导尿管对泌尿外科医生来说是个严重问题。如果未观察到导尿管球囊正确放气，强行拔除可能会导致诸如尿道断裂及随后狭窄形成等灾难性后果。一名60岁男性患者在因早期前列腺癌接受机器人前列腺切除术后20个月出现下尿路症状。膀胱尿道镜检查发现一个移位的Hemolok夹，在吻合部位附近将其取出，随后插入一根留置的Foley导尿管。两周后，患者意外将导尿管拉进尿道。多次尝试给导尿管放气均失败。随后，在经直肠超声（TRUS）引导下经会阴穿刺以使导尿管球囊放气，随后成功拔除导尿管。对于有RALP病史的患者，TRUS引导下经会阴穿刺（局部麻醉下）留置导尿管球囊是一种可行的替代方法。
