V7-07 COMBINED ROBOTIC AND OPEN APPROACH TO EXCISION OF ACCESSORY BLADDER AND URETHRAL TRIPLICATION

Abstract

You have accessJournal of UrologyPediatrics1 Apr 2015V7-07 COMBINED ROBOTIC AND OPEN APPROACH TO EXCISION OF ACCESSORY BLADDER AND URETHRAL TRIPLICATION Diana K. Bowen, Alex P. Glaser, Jonathan W. Bush, Earl Y. Cheng, and Edward M. Gong Diana K. BowenDiana K. Bowen More articles by this author , Alex P. GlaserAlex P. Glaser More articles by this author , Jonathan W. BushJonathan W. Bush More articles by this author , Earl Y. ChengEarl Y. Cheng More articles by this author , and Edward M. GongEdward M. Gong More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.1938AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Management of urethral and bladder duplication anomalies focuses on prevention of recurrent infections and preservation of renal function. We describe a case of urethral triplication and bladder duplication, and the combined robotic and open approach to surgical excision. METHODS A 17 year-old male presented with ten days of intermittent fevers and abdominal pain. He was found to have two accessory urethras – both along the dorsal penile shaft – in addition to a normal orthotopic ventral meatus. A large cavity anterior to the bladder was identified on CT scan and a drain was placed by interventional radiology with return of purulent fluid. He was placed on culture-directed antibiotics and improved. RESULTS Cystoscopy revealed two accessory urethral channels that were both blind-ending, the more proximal one just under the pubic symphysis. The patient then underwent open excision of the urethral triplication followed by robotic excision of the bladder duplication. Total console time for the robotic portion was 2 hours 18 minutes and estimated blood loss was 30 ml. Final pathology revealed non-keratinizing squamous lining of the accessory urethras, with chronic inflammation and marked fibrosis of the distal-most channel, but acute inflammation of the proximal channel. The accessory bladder specimen had a urothelial lining with reactive changes and inflammation within the lamina propria. CONCLUSIONS To our knowledge, this is the first reported case of robotic excision of a urethral/bladder duplication anomaly. There was significant scarring due to the patient's prior recurrent infections, but visualization with the robotic approach was excellent and the patient healed well with a short recovery time. We conclude that robotic excision of a bladder duplication anomaly is a technically feasible operation. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e661 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Diana K. Bowen More articles by this author Alex P. Glaser More articles by this author Jonathan W. Bush More articles by this author Earl Y. Cheng More articles by this author Edward M. Gong More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...