Miyata Yushi, Kiuchi Hiroshi, Yoshioka Fumie, Soda Tetsuji, Sekii Kenichiro
Urology, Osaka Central Hospital, Osaka, JPN.
Cureus. 2025 Apr 24;17(4):e82889. doi: 10.7759/cureus.82889. eCollection 2025 Apr.
A 46-year-old male presented with a prostate-specific antigen (PSA) level of 4.27 ng/mL. MRI identified a Prostate Imaging Reporting and Data System category 4 lesion in the right peripheral zone. Prostate biopsy confirmed adenocarcinoma with a Gleason score of 3+3. The patient was diagnosed with localized prostate cancer (cT2aN0M0) and underwent robot-assisted laparoscopic radical prostatectomy via a transperitoneal approach. Postoperatively, urine was immediately observed through the intraperitoneal drain. To address the anastomotic urinary leakage (AUL), gentle traction of the urethral catheter was applied and secured with abdominal tape. However, on postoperative day 8, the patient developed severe abdominal pain. A CT scan revealed fluid accumulation around the bladder, liver, and spleen, along with ventral migration of the drain, indicating inadequate urine drainage. Standard AUL management strategies had proven ineffective, complicating the case. Ultimately, fixation of the urethral catheter at the external urethral meatus using adhesive tape successfully resolved the leakage and alleviated the abdominal pain. This simple technique may offer an effective alternative for managing AUL.
一名46岁男性，前列腺特异性抗原（PSA）水平为4.27 ng/mL。磁共振成像（MRI）在右侧外周区发现一个前列腺影像报告和数据系统（PI-RADS）4类病变。前列腺活检证实为腺癌，Gleason评分为3+3。该患者被诊断为局限性前列腺癌（cT2aN0M0），并通过经腹途径接受了机器人辅助腹腔镜根治性前列腺切除术。术后，通过腹腔引流管立即观察到尿液。为处理吻合口尿漏（AUL），对尿道导管进行轻柔牵引并用腹带固定。然而，术后第8天，患者出现严重腹痛。CT扫描显示膀胱、肝脏和脾脏周围有积液，引流管向腹侧移位，提示尿液引流不畅。标准的AUL管理策略已证明无效，使病情复杂化。最终，使用胶带将尿道导管固定在外尿道口成功解决了漏尿问题并缓解了腹痛。这种简单技术可能为处理AUL提供一种有效的替代方法。
