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Surgical Neurology International 2022The most commonly used technique in the management of hydrocephalus is a neurosurgical procedure, known as ventriculoperitoneal shunt (VPS). Several complications of the...
Rare case of migration and perforation of the urinary bladder by ventriculoperitoneal shunt catheter with intravesical knotted formation: A case report and literature review.
BACKGROUND
The most commonly used technique in the management of hydrocephalus is a neurosurgical procedure, known as ventriculoperitoneal shunt (VPS). Several complications of the distal end of a VPS catheter have been described in the literature, although migration and erosive bladder perforation of this shunt are extremely uncommon.
CASE DESCRIPTION
We relate a rare pediatric case of a 4-year-old boy, with long-term dysuria, intermittent incontinence, and chronic abdominal pain developed during a myelomeningocele postoperative period, without other symptoms. A bladder fistula with the distal end of the VPS inside the bladder was observed while performing an ultrasound to investigate the urinary tract. Two months before the current surgical approach, the patient, with hydrocephalus and alterations compatible with Chiari malformation, was treated with VPS and subsequently subjected to the third ventriculostomy. The child was unsuccessfully treated with an infraumbilical laparotomy, with section and careful traction of the catheter. A vesicostomy was then performed and the catheter was observed to form an intravesical knot.
CONCLUSION
The intravesical knot formation is extremely rare and its mechanism of formation is still not well understood. Patients with VPS need adequate medical follow-up to identify possible complications of the shunt.
PubMed: 35399874
DOI: 10.25259/SNI_804_2021 -
Urology Case Reports Jan 2021A healthy 25 year old woman presented with acute urinary retention following alcohol ingestion. A 14 french foley catheter drained over 1 L of haematuria immediately....
A healthy 25 year old woman presented with acute urinary retention following alcohol ingestion. A 14 french foley catheter drained over 1 L of haematuria immediately. Due to worsening and persistent abdominal pain, CT and ultrasound imaging was performed, demonstrating only a small amount of free fluid. Diagnostic laparoscopy revealed an intraperitoneal bladder perforation with the foley catheter visible. The bladder defect was repaired and she recovered well. This is a rare case of likely iatrogenic bladder perforation from simple catheterisation without predisposing comorbidities, highlighting the importance of correct technique and awareness of potential complications.
PubMed: 33102129
DOI: 10.1016/j.eucr.2020.101446 -
Acta Obstetricia Et Gynecologica... Aug 2020The retropubic tension-free vaginal tape procedure has been the preferred method for primary surgical treatment of stress and stress-dominant mixed urinary incontinence...
INTRODUCTION
The retropubic tension-free vaginal tape procedure has been the preferred method for primary surgical treatment of stress and stress-dominant mixed urinary incontinence in women for more than 20 years. In this study, we assessed associations between surgeon's experience with the primary tension-free vaginal tape procedure and both perioperative complications and recurrence rates.
MATERIAL AND METHODS
Using a consecutive case-series design, we assessed 596 patients treated with primary retropubic tension-free vaginal tape surgery performed by 18 surgeons from 1998 through 2012, with follow up through 2015 (maximum follow-up time: 10 years per patient). Data on perioperative complications and recurrence of stress urinary incontinence from medical records was transferred to a case report form. Surgeon's experience with the tension-free vaginal tape procedure was defined as number of such procedures performed as lead surgeon (1-19 ["beginners"], 20-49 and ≥50 procedures). All analyses were done with a 5% level of statistical significance. We applied the Chi-square test in the assessment of perioperative complications. The regression analyses of recurrence rate by number of tension-free vaginal tape procedures performed were restricted to the three surgeons who performed ≥50 procedures.
RESULTS
We found a significantly higher rate of bladder perforations (P = .03) and a higher rate of urinary retentions among patients whose tension-free vaginal tape procedures were performed by "beginners" (P = .06). We observed a significant reduction in recurrence rates with increasing number of tension-free vaginal tape procedures for one surgeon (P = .03).
CONCLUSIONS
Surgeon's experience with the tension-free vaginal tape procedure is associated with the risk of bladder perforation and urinary retention, and may be associated with the long-term effectiveness of the procedure.
Topics: Adult; Aged; Aged, 80 and over; Clinical Competence; Female; Humans; Middle Aged; Norway; Postoperative Complications; Risk Factors; Suburethral Slings; Urinary Bladder; Urinary Incontinence, Stress; Urinary Retention; Urologic Surgical Procedures
PubMed: 32104906
DOI: 10.1111/aogs.13830 -
Journal of Clinical and Diagnostic... May 2013Animal related injuries are frequently reported in India and other countries, where bulls are used for sporting events as well as in places where farming and livestock...
Animal related injuries are frequently reported in India and other countries, where bulls are used for sporting events as well as in places where farming and livestock rearing is practised. The presentation is, many times, atypical and misleading as well. They have unique mechanics of injury. The patterns of the injury are reviewed. An intra-peritoneal urinary bladder injury which is caused by a perineal bull gore with a pneumoperitoneum is unusual and it has not been reported in the literature which was reviewed. We are reporting a successfully treated 25 years old male patient from the slopes of the southern district of Manipur, India, who had presented 40 hours after he was injured. The identification and prompt exploration, keeping in mind the mechanics of bull goring, helps the surgeons to adequately deal such atypical injuries, for optimal outcomes.
PubMed: 23814738
DOI: 10.7860/JCDR/2013/5556.2981 -
Journal of Endourology Case Reports 2018Holmium laser enucleation of the prostate (HoLEP) is an attractive and well-studied alternative to transurethral resection of the prostate and open prostatectomy for...
Holmium laser enucleation of the prostate (HoLEP) is an attractive and well-studied alternative to transurethral resection of the prostate and open prostatectomy for the treatment of benign prostatic hyperplasia. There remains an established steep learning curve with relatively few complications described in the literature. A unique risk of HoLEP is injury of the bladder during morcellation of the adenoma and potential iatrogenic intraperitoneal bladder rupture. We present a rare complication of HoLEP demonstrated by two patients in which capsular perforation resulted in subsequent abdominal distention secondary to a large amount of irrigation fluid that leaked into the extraperitoneal space. Uniquely, these cases were managed differently, and serve as guidance to the HoLEP practitioner in postoperative management. The first case involved a 74-year-old male who was found to have significant abdominal distention at the end of the procedure. Given an acute change in stability and concern for bladder injury during morcellation, a minilaparotomy was performed only to reveal extraperitoneal extravasation without intraperitoneal bladder injury or perforation. In the second case, a 78-year-old male undergoing HoLEP had a similar presentation of significant abdominal distention at the conclusion of morcellation. Given a low suspicion for any bladder injury, the patient was managed conservatively with diuretics. He was subsequently discharged on postoperative day 1. Capsular perforation is not a rare phenomenon that occurs during HoLEP. Rarely, perforations can lead to extravasation of irrigation fluid into the extraperitoneal space masquerading as a potential bladder injury related to morcellation because of the associated abdominal distention. This presentation can occur in large glands or early in a surgeon's learning curve when operative times are longer. When there is clear evidence to suggest there is no bladder injury, these cases can be managed conservatively and avoid the morbidity of an abdominal exploration.
PubMed: 29938230
DOI: 10.1089/cren.2018.0021 -
Urologia Internationalis 2020To compare the efficacy and safety of transurethral laser surgery and transurethral resection of a bladder tumor (TURBT) for non-muscle-invasive bladder cancer (NMIBC). (Comparative Study)
Comparative Study Meta-Analysis
OBJECTIVE
To compare the efficacy and safety of transurethral laser surgery and transurethral resection of a bladder tumor (TURBT) for non-muscle-invasive bladder cancer (NMIBC).
MATERIAL AND METHODS
A research was carried out in Medline via PubMed, EMBASE, the Cochrane Library, and Web of Science up to October 20, 2019, to identify articles related to transurethral laser surgery and TURBT for NMIBC. All analyses were done using RevMan5.3 and Stata14.
RESULTS
A total of 17 studies involving 2,439 participants were included. The analysis showed no significant difference in operation times (mean difference = -0.2; 95% CI -2.29 to 1.89; p = 0.85) or occurrences of urethral stricture (OR = 0.7; 95% CI 0.24-2.06; p = 0.52). Transurethral laser surgery was associated with a lower incidence of obturator nerve reflex (OR = 0.04; 95% CI 0.02-0.09; p < 0.00001) and bladder perforation (OR = 0.09; 95% CI 0.04-0.23; p < 0.00001), a higher rate of detrusor muscle acquisition (OR = 5.28; 95% CI 2.42-11.49; p < 0.0001), shorter catheterization (mean difference = -1.05; 95% CI -1.41 to -0.68; p < 0.00001) and hospitalization times (mean difference = -0.96; 95% CI -1.59 to -0.33; p = 0.003), and lower rates of bladder irrigation (OR = 0.21; 95% CI 0.13-0.35; p < 0.00001) and recurrence both at 12 months (OR = 0.66; 95% CI 0.48-0.9, p = 0.008) and at 24 months (OR = 0.6; 95% CI 0.41-0.86; p = 0.005).
CONCLUSIONS
Transurethral laser surgery for NMIBC, as compared to TURBT, is associated with a lower incidence of complications, a lower recurrence rate, and faster postoperative recovery.
Topics: Cystectomy; Humans; Laser Therapy; Neoplasm Invasiveness; Treatment Outcome; Urethra; Urinary Bladder Neoplasms
PubMed: 32460292
DOI: 10.1159/000506655 -
Advanced Biomedical Research 2021Retropubic midurethral sling (MUS) is safe and effective surgery used for the treatment of stress urinary incontinence in women. Bladder neck perforation is a rare...
Retropubic midurethral sling (MUS) is safe and effective surgery used for the treatment of stress urinary incontinence in women. Bladder neck perforation is a rare intraoperative complication. If this complication missed in intraoperative cystoscopy may have serious morbidity. A 52-year-old woman underwent a retropubic MUS. She presented with early and unusual symptoms such as suprapubic and labial cellulitis and urine leakage through the suprapubic incision 1 week after surgery which was due to a missed bladder neck perforation during surgery. In cystoscopy after MUS revealed mesh traversing the bladder neck and it was removed. The missed bladder perforation may have early and unusual symptoms and cystoscopy must be done more carefully and obsessively in patients with risk factors.
PubMed: 34909427
DOI: 10.4103/abr.abr_288_20 -
Journal of the National Medical... Jul 1983Perforated bowel or diseases of the retroperitoneal organs may be complicated by retroperitoneal abscess formation. Six cases of retroperitoneal abscess treated at Ife...
Perforated bowel or diseases of the retroperitoneal organs may be complicated by retroperitoneal abscess formation. Six cases of retroperitoneal abscess treated at Ife University Teaching Hospital, Ile-Ife, Nigeria, over a two-year period are reported. Delayed presentation was responsible for the only death in the series and was also associated with prolonged morbidity in the remaining five cases. Early presentation and diagnosis, use of appropriate antibiotics, and prompt surgical intervention are factors that appear to influence the morbidity of the disease.
Topics: Abscess; Adolescent; Adult; Appendicitis; Female; Humans; Intestinal Perforation; Male; Middle Aged; Radiography; Retroperitoneal Space; Tuberculosis, Pulmonary; Urinary Bladder Calculi
PubMed: 6887273
DOI: No ID Found -
Il Giornale Di Chirurgia 2014To compare mini-sling and traditional tension-free operations for female stress urinary incontinence. (Review)
Review
OBJECTIVES
To compare mini-sling and traditional tension-free operations for female stress urinary incontinence.
STUDY DESIGN
A systematic review of articles in the Literature published between 2002 and 2012, was conducted. A Pubmed search was performed. Primary outcomes were subjective and objective cure rates at 12 months comparing the three single-incision mini-slings techniques (TVT-Secur, MiniArc and Monarc systems) with the standard midurethral sling procedure TOT (Transobturator Vaginal Tape). Secondary outcomes included peri-operative (vaginal and/or bladder perforation, urine retention, urinary tract infection, bleeding, pain) and post-operative (mesh exposure, de novo urgency, and dyspareunia) complications.
RESULTS
In term of objective cure rate at 12 month after surgery, it is evident that TOT at first, and MiniArc are the most effective procedures. The incidence of post-operative urgency and UTI was lower in TOT technique, while vaginal perforation was described in equal frequency both in TOT and in MiniArc procedures. The advantages of the three above described mini-invasive techniques seem to consist into lower cases of urinary retention, pain and bleeding. Furthermore, bladder perforation and bleeding are not described in the Literature for TVT-Secur and Monarc systems.
CONCLUSIONS
Some single-incision slings look promising and as effective as conventional sub-urethral slings at short term evaluation. However, at this moment a clear statement in favor of the widespread use of single-incision slings cannot be made. More studies must define the efficacy of these techniques.
Topics: Female; Humans; Prostheses and Implants; Suburethral Slings; Treatment Outcome; Urinary Incontinence, Stress; Urologic Surgical Procedures; Vagina
PubMed: 24841685
DOI: No ID Found -
Journal of Biophotonics Feb 2020Existing approaches for early-stage bladder tumor diagnosis largely depend on invasive and time-consuming procedures, resulting in hospitalization, bleeding, bladder...
Existing approaches for early-stage bladder tumor diagnosis largely depend on invasive and time-consuming procedures, resulting in hospitalization, bleeding, bladder perforation, infection and other health risks for the patient. The reduction of current risk factors, while maintaining or even improving the diagnostic precision, is an underlying factor in clinical instrumentation research. For example, for clinic surveillance of patients with a history of noninvasive bladder tumors real-time tumor diagnosis can enable immediate laser-based removal of tumors using flexible cystoscopes in the outpatient clinic. Therefore, novel diagnostic modalities are required that can provide real-time in vivo tumor diagnosis. Raman spectroscopy provides biochemical information of tissue samples ex vivo and in vivo and without the need for complicated sample preparation and staining procedures. For the past decade there has been a rise in applications to diagnose and characterize early cancer in different organs, such as in head and neck, colon and stomach, but also different pathologies, for example, inflammation and atherosclerotic plaques. Bladder pathology has also been studied but only with little attention to aspects that can influence the diagnosis, such as tissue heterogeneity, data preprocessing and model development. The present study presents a clinical investigative study on bladder biopsies to characterize the tumor grading ex vivo, using a compact fiber probe-based imaging Raman system, as a crucial step towards in vivo Raman endoscopy. Furthermore, this study presents an evaluation of the tissue heterogeneity of highly fluorescent bladder tissues, and the multivariate statistical analysis for discrimination between nontumor tissue, and low- and high-grade tumor.
Topics: Humans; Multivariate Analysis; Neoplasm Grading; Spectrum Analysis, Raman; Urinary Bladder Neoplasms
PubMed: 31617683
DOI: 10.1002/jbio.201960025