Case report: delayed hemorrhage from an accessory internal pudendal artery pseudoaneurysm after robotic radical prostatectomy: successful management with ct angiography and embolization.
We present the first report of a pseudoaneurysm of an accessory internal pudendal artery after transperitoneal robotic radical prostatectomy. The vesicourethral anastomosis was performed using two continuous 3-0 Monocryl sutures tied at the six o'clock position. As the anastomotic suture was placed at 11 o'clock, lateral to the dorsal venous complex, there was a small amount of pulsatile bleeding that ceased when the suture was completed and tied. The lesion presented as hematuria beginning on the fourth day. On the 14(th) day, the pseudoaneurysm was diagnosed by CT angiography and treated by embolization with eight 3-mm/30-mm micro coils after superselective catheterization. There were no complications or further hematuria.
Beckley
I
I
Department of Urology, Charing Cross Hospital, London, UK. ianbeckley@yahoo.co.uk
Patterson
B
B
Hamaday
M
M
Vale
J
J
Hrouda
D
D
D017541:Aneurysm, False / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy; D000792:Angiography; D004621:Embolization, Therapeutic; D006801:Humans; D007083:Iliac Artery; D008297:Male; D008875:Middle Aged; D019106:Postoperative Hemorrhage / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy; D011468:Prostatectomy / Q000009:adverse effects* / Q000379:methods; D011471:Prostatic Neoplasms / Q000601:surgery*; D012371:Robotics; D013997:Time Factors