Kunitsky Kevin D, Almajedi Mustafa, Snajdar Elizabeth, Adams Parker, Nelson Ryan
Department of Urology, Kansas City University, Kansas City, USA.
Department of Urology, McLaren Macomb, Mount Clemens, USA.
Cureus. 2024 Jan 30;16(1):e53235. doi: 10.7759/cureus.53235. eCollection 2024 Jan.
Urachal anomalies and their associated disease processes are quite rare in pediatric populations and even rarer in adults. Although often asymptomatic, patients with symptoms can be treated with a combination of surveillance, antibiotics, and sometimes surgical resection. In this case, we describe our experience using the single-port robotic approach for the excision of a symptomatic urachal remnant. The patient presented with a chief complaint of urinary frequency, dysuria, intermittent hematuria, and right flank pain. A CT scan of the abdomen and pelvis revealed a bladder wall thickening at the dome of the bladder measuring 2.6 x 3.6 x 1.5 cm with concerns for adenocarcinoma. The patient subsequently underwent a biopsy, which was benign. The patient's symptoms persisted, and she elected to undergo surgical resection. Postoperatively, her symptoms resolved, and she was satisfied with her treatment outcome. This case exemplifies the feasibility of the single-port robotic approach to urachal remnant excision, with further applicability to simple transabdominal robotic bladder surgery.
脐尿管异常及其相关疾病在儿科人群中相当罕见,在成人中更为罕见。尽管通常无症状,但有症状的患者可通过监测、抗生素治疗,有时还需手术切除来进行治疗。在此病例中,我们描述了使用单孔机器人手术方法切除有症状脐尿管残余物的经验。患者的主要诉求为尿频、尿痛、间歇性血尿和右侧胁腹疼痛。腹部和骨盆的CT扫描显示膀胱顶部膀胱壁增厚,大小为2.6×3.6×1.5厘米,怀疑为腺癌。患者随后接受了活检,结果为良性。患者症状持续存在,她选择接受手术切除。术后,她的症状得到缓解,对治疗结果感到满意。该病例证明了单孔机器人手术方法切除脐尿管残余物的可行性,进一步适用于简单的经腹机器人膀胱手术。