Minimally invasive treatment of vesicourethral leak after laparoscopic radical prostatectomy

Abstract

o estudo mostrou que a FAVP após a prostatectomia radical laparoscópica pode ser tratada por via endoscópica com segurança e excelentes resultados.

Percutaneous embolization of contained iatrogenic vesicourethral fistula using AVP and NBCA: a case report

“…Persistent vesicourethral anastomotic leakage is a significant loss of urine, usually above 100 or 200 ml, after the third day postoperatively. The prevalence of persistent vesicourethral anastomotic leakage is low, and there are only a few published cases reporting that the leakage is difficult to control and increases the possibility of extended hospital stay in addition to the risk of other complications [8][9][10].…”

“…Treatment of vesicourethral anastomotic leakage is challenging, and this complication can indefinitely prolong the hospitalization period and add the risk of adverse events such as secondary infection by resistant germs [8].…”

Successful body flossing via indwelling nephrostomy allowing for primary realignment of bladder rupture and placement of a foley catheter into the urinary bladder

“…In the last 2-10 years of PVAL, the practiced methods include; directing the flow of urine by endoscopically inserting 2 urethral catheters [6], similarly exteriorization of ureteral stents via the urethra to temporarily divert urine flow [8], injection of N-butyl-2-cyanoacrylate and by fibrin glue into the vesicourethral anastomotic gap via cystoscopy [12], or more recently, using a self-made fenestrated foley catheter [13].…”

“…The vesicouretheral anastomosis between the bladder neck and the membranous urethra for reconstruction of the lower urinary tract after removal of the prostate is a crucial point of RALP. Urinary leakage at the urethrovesical anastomosis is the most common short-term complications of RP but is usually self-limited and last about 2-3 days [6]. Persistent (not self-limiting within 2-5 days) vesicourethral anastomotic leaks (PVAL) is a rare occurrence with an unclear incidence, about which there is a paucity of published literature.…”