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后腹腔镜膀胱颈闭合术治疗福尼尔坏疽所致的持续性尿失禁

Retroperitoneoscopic bladder neck closure for continuous urinary incontinence in Fournier's gangrene.

作者信息

Doi Yukiko, Ochi Atsuhiko, Okamoto Yuma, Komiya Akira, Kuji Hiroshi, Suzuki Koichiro, Shiga Naoki, Abe Hirokazu

机构信息

Department of Urology Kameda Medical Center Kamogawa City Chiba Japan.

Department of Urology The Jikei University School of Medicine Tokyo Japan.

出版信息

IJU Case Rep. 2024 Sep 20;7(6):495-498. doi: 10.1002/iju5.12788. eCollection 2024 Nov.

Abstract

INTRODUCTION

A retroperitoneoscopic procedure for bladder neck closure has not yet been described.

CASE PRESENTATION

Case 1 was a 56-year-old man who underwent clean intermittent catheterization for spastic paraplegia due to a thoracic spinal cord injury 37 years prior. Case 2 was an 80-year-old bedridden woman who underwent urethral catheterization after a femoral fracture and brain infarction 3 years prior. Both patients presented with Fournier's gangrene, and the urogenital region, including the necrotic urethra, was debrided. Although a permanent suprapubic catheter was established, postoperative wound healing was poor owing to continuous urine leakage from the urethral stump. Therefore, we performed retroperitoneoscopic bladder neck closure, and the urinary incontinence was completely resolved.

CONCLUSION

Retroperitoneoscopic bladder neck closure is a feasible and less invasive procedure for treating continuous urinary incontinence from the urethral stump in patients with Fournier's gangrene after surgical debridement and having a permanent suprapubic catheter.

摘要

引言

尚未有关于经后腹腔镜膀胱颈闭合术的描述。

病例报告

病例1是一名56岁男性,37年前因胸段脊髓损伤导致痉挛性截瘫,接受清洁间歇性导尿。病例2是一名80岁卧床女性,3年前因股骨骨折和脑梗死接受尿道插管。两名患者均出现福尼尔坏疽,对包括坏死尿道在内的泌尿生殖区域进行了清创。尽管已留置永久性耻骨上导管,但由于尿道残端持续漏尿,术后伤口愈合不佳。因此,我们进行了经后腹腔镜膀胱颈闭合术,尿失禁完全得到解决。

结论

经后腹腔镜膀胱颈闭合术是一种可行且侵入性较小的手术,用于治疗福尼尔坏疽患者在手术清创并留置永久性耻骨上导管后尿道残端持续尿失禁。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/323c/11531883/b26fde2b0266/IJU5-7-495-g004.jpg

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