Vesicourethral anastomosis leaks are not uncommon following radical prostatectomy. We present a case of a 59-year-old male who presented to our ED with hematuria, abdominal pain, and clot retention 17 days after a robotic-assisted laparoscopic prostatectomy. A 50% vesicourethral disruption was ultimately managed endoscopically and with hemostatic agents. At 9-month follow-up he is fully continent with normal erectile function. Vesicourethral leaks can typically be managed conservatively with gentle traction and prolonged catheterization. Persistent hematuria can complicate management, and hemostatic agents may allow for completely endoscopic management with minimal morbidity as seen in this case.
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Urology case reports. 2017 Jan 07*** epublish ***
Charles J Paul, Conrad M Tobert, Chad R Tracy
University of Iowa, Department of Urology, 200 Hawkins Drive, Iowa City, IA 52242, USA.