Robot-assisted laparoscopic excision of symptomatic retrovesical cysts in boys and young adults.
OBJECTIVE
We review our surgical experience with the management of retrovesical cystic anomalies using robot-assisted laparoscopic techniques.


METHODS
We retrospectively reviewed the presentation, diagnosis and treatment of 6 patients 28 months to 22 years old with retrovesical cystic anomalies who underwent robot-assisted laparoscopic excision at our hospital between January 2006 and November 2010.


RESULTS
Presenting signs and symptoms included urinary retention, lower urinary tract symptoms, abdominal pain and repeated epididymitis. Associated anomalies consisted of hypospadias, vesicoureteral reflux, renal agenesis, 5alpha-reductase deficiency, premature adrenarche and cryptorchidism. Cystic anomalies ranged from 3 to 6 cm long. The final diagnoses were prostatic utricular cyst, müllerian duct cyst and seminal vesicle cyst. Ectopic insertion of vas into the cyst was found in 4 cases, requiring ligation of the affected vas in 3. Mean ± SD operative time including cystoscopy was 198 ± 23.8 minutes, and estimated blood loss ranged from 5 to 10 ml. Mean ± SD hospital stay was 1.33 ± 0.52 days. All patients had resumed their regular activities within 2 weeks postoperatively. De novo contralateral epididymitis developed 2 months postoperatively in 1 patient. Otherwise, there was no recurrence of cystic mass or presenting signs or symptoms during followup of 3 to 56 months.


CONCLUSIONS
In the management of retrovesical cystic anomalies robot-assisted laparoscopic excision affords a natural extension of conventional laparoscopy with the additional advantages of 3-dimensional vision and ease of instrument control.
Department of Urology, Children's Hospital Boston, Harvard Medical School, Boston, Massachusetts 02115, USA.
Young Kwon
YK
Hong
Bulent
B
Onal
David A
DA
Diamond
Alan B
AB
Retik
Marc
M
Cendron
Hiep T
HT
Nguyen
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003560:Cysts / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D009095:Mullerian Ducts / Q000002:abnormalities; D012189:Retrospective Studies; D012371:Robotics; D001743:Urinary Bladder; D055815:Young Adult