Hem-o-Lok^® clip eroding into the urethra following laparoscopic radical prostatectomy: A case report and review of literature

Abstract

Hem-o-loc clips have been used for vascular control in laparoscopic surgery. We describe a case presenting with lower urinary tract symptoms after laparoscopic radical prostatectomy. Evaluation revealed migrated hem-o-loc clips causing obstruction and symptoms in bladder neck region. Clip removal with endoscopy relieved the symptoms. Diagnosis warrants high index of suspicion as clips are radiolucent and other more common differential diagnosis like bladder neck contracture may have similar presentation. For the prevention, loose clips should be actively searched for and retrieved from abdomen and clip application near proposed anastomotic site should be avoided.

Migrated Hem-o-lok clip in the bladder: A rare cause of bladder stone for cystolitholapaxy

“…Some patients may exhibit signs of anxiety during sexual history-taking or exhibit reluctance toward genital or rectal examinations. Clinical presentations of urinary bladder foreign bodies can range from asymptomatic to experiencing symptoms such as dysuria, hematuria, frequency, poor stream, suprapubic pain, urinary retention, and chronic pelvic pain 1 .…”

“…Bladder migration of a Hem-o-loc® clip, which is a potential complication of robotic-assisted radical prostatectomy (RARP), is a late post-operative issue associated with robotic surgeries that may go undetected in the long term. 1 To minimize the risk of bladder and urethral injuries, minimally invasive procedures are generally recommended.…”