[Ultrasonography-guided transrectal perineal drainage of retroanastomotic collections in orthotopic neobladder].
Pelvic collections are not an uncommon complication of pelvic surgery. Usually, such a complications are managed by TC-guided percutaneous drainage or even by more invasive surgical operations. Here, we describe a transperineal TRUS-guided drainage technique of pelvic urinomas occurring after a radical cystectomy (RC) for invasive Bladder Cancer (BC) in two patients, respectively 55 and 77 YOM. Respectively, 10 and 20 days after catheter had been taken out patients began complaining a severe pelvic pain associated to fever (over 40 degrees C). Physical examination and an ultrasound, followed by a CT-scan, showed a huge retroanastomotic pelvic urinoma (width over 10 cm). CT-guided percutaneous drainage was considered at increased risk of iatrogenic injury of mesenterial neobladder because of its location. A TRUS-guided percutaneous perineal drainage of urinomas with a pig-tail 8 ch was carried out. Urinomas were successfully drained and no significant complications were encountered. At a median follow-up of 11 months no late complications were found. Our preliminary experience with this procedure is favourable regarding mininvasivity, lack of complications and its feasibility by urologists themselves. Its impact on cost/benefit rate is favorable too. We believe that this technique might be considered as an alternative to CT-guided percutaneous drainage.
Coppola
Piero
P
U.O.A. Urologia, Ospedale S.G. Bosco, Torino.
Cosma
Luigi
L
Bardari
Franco
F
D'Urso
Leonardo
L
Muto
Giovanni
G
D000368:Aged; D015653:Cystectomy / Q000009:adverse effects*; D004322:Drainage / Q000379:methods*; D006801:Humans; D008875:Middle Aged; D010388:Pelvis; D010502:Perineum; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000628:therapy; D012007:Rectum; D014463:Ultrasonography; D014556:Urine