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Minerva Urologica e Nefrologica 2020 Jan 29

DOI: 10.23736/S0393-2249.19.03628-2

Copyright © 2019 EDIZIONI MINERVA MEDICA

language: English

How to manage a partial detachment of the ureter - too close to the anastomosis line- during robotic radical prostatectomy?

Fabrizio DAL MORO 1, 2 , Federico GOFFO 2, Giordana FERRAIOLI 2, Carlotta ZABORRA 2, Claudio VALOTTO 1

1 Department of Medicine, Urology, University Hospital of Udine, Udine, Italy; 2 Department of Surgery, Oncology and Gastroenterology, Urology, University of Padua, Padua, Italy


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The management of a ureteral orifice injury occurring during robotic radical prostatectomy (RARP) represents a challenge for urologists. Several techniques have been proposed to treat an intraoperative injury, but intraoperative positioning of a DJ stent represents the most common treatment in cases of a partial injury of the ureteral orifice. We present a technique to ensure the successful outcome in cases of a partial detachment of the ureter during RARP. When the orifice is identified after the incision of the bladder neck and it appears very close to the anastomosis line setting up a partial detachment of the ureter, before implanting a DJ stent, one tip could be to perform a small incision of the anterior wall of the orifice to spatulate it and then proceeding to a short slip of the ureter: the eversion of the mucosa - creating a sort of “folded shirt cuff”- allows the fixation of the ureter to the bladder wall. We successfully performed this technique in two cases of RARP.


KEY WORDS: Prostate cancer; Incidental prostate cancer; Transurethral resection of the prostate; Prostate tumor grade

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