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Minimally invasive surgical approach to treat posterior urethral diverticulum.

Alsowayan O, Almodhen F, Alshammari A - Urol Ann (2015 Apr-Jun)

Bottom Line: It may occur at any point along the urethra in both male and females.Male urethral diverticulum is rare, and could be either congenital or acquired, anterior or posterior.Here we discuss our minimally invasive surgical approach (MIS) in managing posterior urethral diverticulum.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, Division of Pediatric Urology, King Saud bin Abdul Aziz University for Health Sciences, King Abdul Aziz Medical City, Riyadh, KSA.

ABSTRACT
Urethral diverticulum is a localized saccular or fusiform out-pouching of the urethra. It may occur at any point along the urethra in both male and females. Male urethral diverticulum is rare, and could be either congenital or acquired, anterior or posterior. The mainstay treatment of posterior urethral diverticulum (PUD) is the open surgical approach. Here we discuss our minimally invasive surgical approach (MIS) in managing posterior urethral diverticulum.

No MeSH data available.


Related in: MedlinePlus

Robotic assisted laparoscopic posterior urethral diverticulectomy
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Figure 6: Robotic assisted laparoscopic posterior urethral diverticulectomy

Mentions: 4-year-old boy known case of imperforate anus post perineal pull-thru at neonatal period presented with history of weak stream and recurrent retention episodes. Ultrasound showed smooth bladder wall with normal upper tract. Huge PUD causing intermittent bladder outlet obstruction was detected by VCUG [Figure 5]. The patient was taken to operative room for cystoscopy and robotic assisted laparoscopic diverticulectomy. Cystoscopy showed huge PUD opening at the level of verumontanum on the left side. 8F Foley's catheter was placed into the diverticulum. He was then shifted to supine position. Ports were placed in a similar manner as discussed before in addition to an assistant 5 mm port. Da Vinci robotic surgical system was docked to the side of the patient. A plane between the bladder and rectum was developed where the PUD could be identified. Hitching suture was used to keep the diverticulum under tension. The diverticulum was completely mobilized and its wall excised [Figure 6]. Urethral edges were approximated using 5/0 vicryl suture. 10F foley's catheter was kept in place as a urethral stent. EBL was around 15 cc. The patient was shifted to the floor on IV acetaminophen and cefuroxime and was discharged home on oral acetaminophen, trimethoprim/sulfamethoxazole prophylaxis and foley catheter which was removed after 3 weeks. Follow-up VCUG at 3 months showed good caliber urethra with no strictures [Figure 7] and was able to empty his bladder completely since then.


Minimally invasive surgical approach to treat posterior urethral diverticulum.

Alsowayan O, Almodhen F, Alshammari A - Urol Ann (2015 Apr-Jun)

Robotic assisted laparoscopic posterior urethral diverticulectomy
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4374276&req=5

Figure 6: Robotic assisted laparoscopic posterior urethral diverticulectomy
Mentions: 4-year-old boy known case of imperforate anus post perineal pull-thru at neonatal period presented with history of weak stream and recurrent retention episodes. Ultrasound showed smooth bladder wall with normal upper tract. Huge PUD causing intermittent bladder outlet obstruction was detected by VCUG [Figure 5]. The patient was taken to operative room for cystoscopy and robotic assisted laparoscopic diverticulectomy. Cystoscopy showed huge PUD opening at the level of verumontanum on the left side. 8F Foley's catheter was placed into the diverticulum. He was then shifted to supine position. Ports were placed in a similar manner as discussed before in addition to an assistant 5 mm port. Da Vinci robotic surgical system was docked to the side of the patient. A plane between the bladder and rectum was developed where the PUD could be identified. Hitching suture was used to keep the diverticulum under tension. The diverticulum was completely mobilized and its wall excised [Figure 6]. Urethral edges were approximated using 5/0 vicryl suture. 10F foley's catheter was kept in place as a urethral stent. EBL was around 15 cc. The patient was shifted to the floor on IV acetaminophen and cefuroxime and was discharged home on oral acetaminophen, trimethoprim/sulfamethoxazole prophylaxis and foley catheter which was removed after 3 weeks. Follow-up VCUG at 3 months showed good caliber urethra with no strictures [Figure 7] and was able to empty his bladder completely since then.

Bottom Line: It may occur at any point along the urethra in both male and females.Male urethral diverticulum is rare, and could be either congenital or acquired, anterior or posterior.Here we discuss our minimally invasive surgical approach (MIS) in managing posterior urethral diverticulum.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, Division of Pediatric Urology, King Saud bin Abdul Aziz University for Health Sciences, King Abdul Aziz Medical City, Riyadh, KSA.

ABSTRACT
Urethral diverticulum is a localized saccular or fusiform out-pouching of the urethra. It may occur at any point along the urethra in both male and females. Male urethral diverticulum is rare, and could be either congenital or acquired, anterior or posterior. The mainstay treatment of posterior urethral diverticulum (PUD) is the open surgical approach. Here we discuss our minimally invasive surgical approach (MIS) in managing posterior urethral diverticulum.

No MeSH data available.


Related in: MedlinePlus