Management of prostatosymphyseal fistula following photoselective vaporization of the prostate: Case series and systematic review of the literature.
Fistula
Laser
Prostatosymphyseal fistula
Puboprostatic fistula
Reconstructive surgery
Journal
Current urology
ISSN: 1661-7649
Titre abrégé: Curr Urol
Pays: United States
ID NLM: 101471188
Informations de publication
Date de publication:
Jun 2022
Jun 2022
Historique:
received:
26
05
2021
accepted:
20
12
2021
entrez:
17
10
2022
pubmed:
18
10
2022
medline:
18
10
2022
Statut:
ppublish
Résumé
This study is aimed to describe our institutional experience and review the literature to date on prostatosymphyseal fistula (PSF), or puboprostatic fistula, following bladder outlet procedures such as transurethral resection of the prostate (TURP) or laser photoselective vaporization of the prostate (PVP). We retrospectively queried our institutional experience for management of PSF following PVP performed for symptomatic benign prostatic hyperplasia. We also performed a systematic literature review for PSF following PVP or TURP. Finally, we describe our surgical approach to the management of this challenging condition. We identified 7 cases of PSF following PVP from our institution, as well as an additional 7 cases following PVP and 9 cases following TURP from literature review. The diagnosis of PSF was made between 0.5 and 24 months following PVP, and the most specific symptoms were pubic pain and difficulty ambulating. Most patients requiring several evaluations before the diagnosis was made using appropriate imaging studies. Seventy percent of patients required surgical intervention including fistula repair or prostatectomy. Our surgical approach has evolved, and we now routinely perform robotic fistula repair with Y-V plasty and interposition flap with excellent results. Puboprostatic fistula is a rare and poorly described complication of PVP or TURP. To the best of our knowledge, this case series of PSF following PVP represents the largest series to date and doubles the number of reported cases in the literature. Robotic fistula repair with interposition of either peritoneal or perivesical fat flaps appears to be a viable management strategy.
Sections du résumé
Background
UNASSIGNED
This study is aimed to describe our institutional experience and review the literature to date on prostatosymphyseal fistula (PSF), or puboprostatic fistula, following bladder outlet procedures such as transurethral resection of the prostate (TURP) or laser photoselective vaporization of the prostate (PVP).
Materials and methods
UNASSIGNED
We retrospectively queried our institutional experience for management of PSF following PVP performed for symptomatic benign prostatic hyperplasia. We also performed a systematic literature review for PSF following PVP or TURP. Finally, we describe our surgical approach to the management of this challenging condition.
Results
UNASSIGNED
We identified 7 cases of PSF following PVP from our institution, as well as an additional 7 cases following PVP and 9 cases following TURP from literature review. The diagnosis of PSF was made between 0.5 and 24 months following PVP, and the most specific symptoms were pubic pain and difficulty ambulating. Most patients requiring several evaluations before the diagnosis was made using appropriate imaging studies. Seventy percent of patients required surgical intervention including fistula repair or prostatectomy. Our surgical approach has evolved, and we now routinely perform robotic fistula repair with Y-V plasty and interposition flap with excellent results.
Conclusions
UNASSIGNED
Puboprostatic fistula is a rare and poorly described complication of PVP or TURP. To the best of our knowledge, this case series of PSF following PVP represents the largest series to date and doubles the number of reported cases in the literature. Robotic fistula repair with interposition of either peritoneal or perivesical fat flaps appears to be a viable management strategy.
Identifiants
pubmed: 36246425
doi: 10.1097/CU9.0000000000000090
pii: CURR-UROL-21-0107
pmc: PMC9554891
doi:
Types de publication
Journal Article
Langues
eng
Pagination
88-93Informations de copyright
Copyright © 2022 The Authors. Published by Wolters Kluwer Health, Inc.
Déclaration de conflit d'intérêts
The authors report no conflicts of interest.
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