ABSTRACT
PURPOSE: During laparoscopic partial cystectomy (LPC), lesion identification is essential to help to determine the appropriate bladder incisions required to maintain adequate resection margins. The inability to use tactile senses makes it difficult for surgeons to locate lesions during laparoscopic surgery. Endoscopic India ink marking techniques are often used in laparoscopic gastroenterological surgery. We present our experience with performing LPC with India ink during the surgical resection of various bladder lesions. MATERIALS AND METHODS: LPC with cystoscopic fine needle tattooing was performed on 10 patients at our institute. Tattooing was performed at 1- to 2-cm intervals approximately 1 cm away from the outer margin of the lesion with enough depth (the deep muscle layer) under cystoscopic guidance. LPC was performed by the transperitoneal approach. The clinical courses and pathologic results were analyzed. RESULTS: All LPC with cystoscopic tattooing cases were performed successfully. The mean patient age was 39.1 years. The mean operative time was 130.5 minutes, and the mean estimated blood loss was 93 ml. The mean hospital stay was 13.1 days, and the mean duration of indwelling Foley catheterization was 10.7 days. There were no significant intraoperative or postoperative complications except 1 case of delayed urinary leak and 1 case of delayed wound healing. The pathological diagnosis included 1 urachal cancer, 1 urachal remnant, 4 urachal cysts, 2 pheochromocytomas, and 2 inflammatory masses. All specimens showed adequate surgical margins. CONCLUSIONS: Cystoscopic tattooing in LPC is a simple and effective technique to assist in locating pathological bladder lesions intraoperatively. This technique can help to determine appropriate resection margins during LPC without incurring additional complicated procedures.
Subject(s)
Humans , Carbon , Cystectomy , Cystoscopy , India , Ink , Laparoscopy , Length of Stay , Muscles , Needles , Operative Time , Pheochromocytoma , Postoperative Complications , Tattooing , Urachal Cyst , Urinary Bladder , Urinary Bladder Neoplasms , Urinary Catheterization , Wound HealingABSTRACT
Priapism attributable to an anticoagulant drug has rarely been reported. Although the pathophysiology of this type of priapism is not well understood, most investigators contend that thromboembolic phenomena play either a causative or supportive role. We describe a case of priapism associated with the discontinuation of oral warfarin.
Subject(s)
Humans , Heparin , Priapism , Research Personnel , WarfarinABSTRACT
Neovesical-urethral anastomotic stricture is a complication of orthotopic neobladder, with a reported incidence of 2.7% to 8.8%. Strictures of the neovesico-urethral anastomotic site can be treated with regular self-dilation, but high-grade strictures require a surgical procedure involving incision by electrocautery or cold knife. Here we describe a grade III neovesical-urethral anastomotic stricture after an orthotopic bladder substitution that was successfully treated by use of a ureteral dilation balloon catheter.
Subject(s)
Catheters , Cold Temperature , Constriction, Pathologic , Electrocoagulation , Incidence , Ureter , Urinary Bladder , Urinary Bladder Neck Obstruction , Urinary Bladder Neoplasms , Urinary DiversionABSTRACT
Acute scrotum can occur as a complication of various procedures, such as open, laparoscopic surgeries or diagnostic procedures. We present an unusual case of acute hemiscrotum due to inadvertent gallbladder injury following an ultrasound-guided liver biopsy