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Unorthodox cause of urinary leak post radical prostatectomy: Catheter balloon within a bladder diverticulum – Case report and highlights on various methods to overcome leaks
INTRODUCTION: Radical prostatectomy for prostate cancer has been increasingly adopted, especially for localized disease. Nevertheless, this has not been without any morbidities. Complications, such as urine leak, related to malpositioned or malfunctional indwelling catheters, are rarely reported. PR...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7025078/ https://www.ncbi.nlm.nih.gov/pubmed/32062506 http://dx.doi.org/10.1016/j.ijscr.2020.02.015 |
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author | Degheili, Jad A. Malhas, Haya Yoo, Tag Keun |
author_facet | Degheili, Jad A. Malhas, Haya Yoo, Tag Keun |
author_sort | Degheili, Jad A. |
collection | PubMed |
description | INTRODUCTION: Radical prostatectomy for prostate cancer has been increasingly adopted, especially for localized disease. Nevertheless, this has not been without any morbidities. Complications, such as urine leak, related to malpositioned or malfunctional indwelling catheters, are rarely reported. PRESENTATION OF CASE: A 75-year-old male underwent an open radical prostatectomy for prostate cancer. Soon after surgery, he witnessed urine leak and extravasation. Imaging including a plain CT scan with a retrograde cystography, showed the tip of the indwelling catheter within a diverticular pouch of the bladder; itself possessing two anterior diverticular pouches, giving the shape of a “Mickey-Mouse” like bladder. The balloon was deflated, and the Foley catheter was repositioned within the bladder, under fluoroscopy. The urine leak from the surgical wound and through the urethra, completely vanished. DISCUSSION: Urinary leak due to indwelling catheter malfunction or malposition, post radical prostatectomy, is very rare. Only one similar case has been reported so far. Vesicourethral anastomotic leak post prostatectomy is commonly seen, and mostly due to disruption in the posterior anastomosis. Risk factors for such leaks are various and may include: large prostate, previous transurethral resections, techniques adopted for anastomosis and bladder neck reconstruction, among others. Most leakage cases resolve spontaneously or using conservative measures. Those requiring more aggressive interventions are a minority. CONCLUSION: Urethrovesical anastomotic leaks are commonly seen after radical prostatectomy. Although most cases are self-limited; others can be managed by various minimally-invasive procedures, diverting urine away from the anastomosis, giving it a chance to properly heal. |
format | Online Article Text |
id | pubmed-7025078 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
spelling | pubmed-70250782020-02-20 Unorthodox cause of urinary leak post radical prostatectomy: Catheter balloon within a bladder diverticulum – Case report and highlights on various methods to overcome leaks Degheili, Jad A. Malhas, Haya Yoo, Tag Keun Int J Surg Case Rep Article INTRODUCTION: Radical prostatectomy for prostate cancer has been increasingly adopted, especially for localized disease. Nevertheless, this has not been without any morbidities. Complications, such as urine leak, related to malpositioned or malfunctional indwelling catheters, are rarely reported. PRESENTATION OF CASE: A 75-year-old male underwent an open radical prostatectomy for prostate cancer. Soon after surgery, he witnessed urine leak and extravasation. Imaging including a plain CT scan with a retrograde cystography, showed the tip of the indwelling catheter within a diverticular pouch of the bladder; itself possessing two anterior diverticular pouches, giving the shape of a “Mickey-Mouse” like bladder. The balloon was deflated, and the Foley catheter was repositioned within the bladder, under fluoroscopy. The urine leak from the surgical wound and through the urethra, completely vanished. DISCUSSION: Urinary leak due to indwelling catheter malfunction or malposition, post radical prostatectomy, is very rare. Only one similar case has been reported so far. Vesicourethral anastomotic leak post prostatectomy is commonly seen, and mostly due to disruption in the posterior anastomosis. Risk factors for such leaks are various and may include: large prostate, previous transurethral resections, techniques adopted for anastomosis and bladder neck reconstruction, among others. Most leakage cases resolve spontaneously or using conservative measures. Those requiring more aggressive interventions are a minority. CONCLUSION: Urethrovesical anastomotic leaks are commonly seen after radical prostatectomy. Although most cases are self-limited; others can be managed by various minimally-invasive procedures, diverting urine away from the anastomosis, giving it a chance to properly heal. Elsevier 2020-02-07 /pmc/articles/PMC7025078/ /pubmed/32062506 http://dx.doi.org/10.1016/j.ijscr.2020.02.015 Text en © 2020 The Author(s) http://creativecommons.org/licenses/by/4.0/ This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Degheili, Jad A. Malhas, Haya Yoo, Tag Keun Unorthodox cause of urinary leak post radical prostatectomy: Catheter balloon within a bladder diverticulum – Case report and highlights on various methods to overcome leaks |
title | Unorthodox cause of urinary leak post radical prostatectomy: Catheter balloon within a bladder diverticulum – Case report and highlights on various methods to overcome leaks |
title_full | Unorthodox cause of urinary leak post radical prostatectomy: Catheter balloon within a bladder diverticulum – Case report and highlights on various methods to overcome leaks |
title_fullStr | Unorthodox cause of urinary leak post radical prostatectomy: Catheter balloon within a bladder diverticulum – Case report and highlights on various methods to overcome leaks |
title_full_unstemmed | Unorthodox cause of urinary leak post radical prostatectomy: Catheter balloon within a bladder diverticulum – Case report and highlights on various methods to overcome leaks |
title_short | Unorthodox cause of urinary leak post radical prostatectomy: Catheter balloon within a bladder diverticulum – Case report and highlights on various methods to overcome leaks |
title_sort | unorthodox cause of urinary leak post radical prostatectomy: catheter balloon within a bladder diverticulum – case report and highlights on various methods to overcome leaks |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7025078/ https://www.ncbi.nlm.nih.gov/pubmed/32062506 http://dx.doi.org/10.1016/j.ijscr.2020.02.015 |
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