Skip to main content

Advertisement

SpringerLink
Log in

Surgical treatment of an acquired posterior urethral diverticulum with cystoscopy assisted robotic technique

  • Case Report
  • Published:
Journal of Robotic Surgery Aims and scope Submit manuscript

Abstract

A 42-year-old man with a history of recurrent urethral stenosis, recurrent urinary tract infection and macroscopic hematuria has referred to our clinic. He underwent several internal urethrotomies and currently using clean intermittent self-catheterization. During the internal urethrotomy, we noted a large posterior urethral diverticulum (UD) between verumontanum and bladder neck. His obstructive symptoms were resolved after the catheter removal. But perineal discomfort, urgency and dysuria were prolonged about 3–4 weeks. Urinalysis and urine culture confirmed recurrent urinary tract infections. Due to this conditions and symptoms, we planned a surgical approach which was planned as transperitoneal robotic-assisted laparoscopic approach. This technique is still applied for the diverticulectomy of the bladder. In addition to this we utilized the cystoscopy equipments for assistance. During this process, cystoscope was placed in the UD to help the identification of UD from adjacent tissues like seminal vesicles by its movement and translumination. Operating time was 185 min. On the post-operative third day he was discharged. Foley catheter was removed after 2 weeks. Urination was quite satisfactory. His perineal discomfort was resolved. The pathology report confirmed epidermoid (tailgut) cyst of the prostate. Urethrogram showed no radiologic signs of UD after 4 weeks. Irritative and obstructive symptoms were completely resolved after 3 months. No urinary incontinence, erectile dysfunction or retrograde ejaculation was noted. While posterior UD is an extremely rare situation, surgical treatment of posterior UD remains uncertain. To our knowledge, no above-mentioned cystoscopy assisted robotic technique for the treatment was described in the literature.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4

References

  1. Cinman NM, McAninch JW, Glass AS, Zaid UB, Breyer BN (2012) Acquired male urethral diverticula: presentation, diagnosis and management. J Urol 188(4):1204–1208. doi:10.1016/j.juro.2012.06.036 (Epub 2012 Aug 16)

    Article  PubMed  PubMed Central  Google Scholar 

  2. Allen D, Mishra V, Pepper W et al (2007) A single-center experience of symptomatic male urethral diverticula. Urology 70:650

    Article  PubMed  Google Scholar 

  3. Ortlip SA, Gonzalez R, Williams RD (1980) Diverticula of the male urethra. J Urol 124(3):350–355

    CAS  PubMed  Google Scholar 

  4. Alam S, Lawal TA, Peña A et al (2011) Acquired posterior urethral diverticulum following surgery for anorectal malformation. J Pediatr Surg 46(6):1231–1235

    Article  PubMed  Google Scholar 

  5. Hong AR, Acuña MF, Peña A et al (2002) Urologic injuries associated with repair of anorectal malformations in male patients. J Pediatr Surg 37:339

    Article  PubMed  Google Scholar 

  6. Monish A, Rajeev TP, Dorairajan LN et al (1999) Infected congenital urethral diverticulum in an adult male. Urol Int 62:177

    Article  CAS  PubMed  Google Scholar 

  7. Alsowayan O, Almodhen F, Alshammari A (2015) Minimally invasive surgical approach to treat posterior urethral diverticulum. Urol Ann 7(2):273–276. doi:10.4103/0974-7796.152950

    Article  PubMed  PubMed Central  Google Scholar 

  8. Hong YK, Onal B, Diamond DA, Retik AB, Cendron M, Nguyen HT (2011) Robot-assisted laparoscopic excision of symptomatic retrovesical cysts in boys and young adults. J Urol 186(6):2372–2378. doi:10.1016/j.juro.2011.07.113 (Epub 2011 Oct 20)

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Urology, Private Liv Hospital, Ankara, Turkey

    Cagri Guneri

  2. Department of Urology, Private Koru Hospital, Ankara, Turkey

    Mustafa Kirac & Hasan Biri

Authors
  1. Cagri Guneri
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Mustafa Kirac
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Hasan Biri
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Cagri Guneri.

Ethics declarations

Conflict of interest

The authors of this manuscript, Cagri Guneri, Mustafa Kirac and Hasan Biri have no financial conflicts of interest and nothing to disclose.

Consent section

The procedure performed was in accordance with the ethical standards of the institution and with the 1964 Helsinki declaration and its later amendments. Informed consent was obtained from the patient included in the study and additional written informed consent was obtained from the patient for publication of this case report and the accompanying images. A copy of the written consent is available for review by the Editor-in-Chief of this journal.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Guneri, C., Kirac, M. & Biri, H. Surgical treatment of an acquired posterior urethral diverticulum with cystoscopy assisted robotic technique. J Robotic Surg 11, 83–86 (2017). https://doi.org/10.1007/s11701-016-0623-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11701-016-0623-7

Keywords

Search

Navigation