Bladder injuries during laparoscopic orchiopexy: incidence and lessons learned
Michael H Hsieh1, Aaron Bayne, Lars J Cisek
1Scott Department of Urology, Baylor College of Medicine, Houston, Texas, USA. mhhsieh@stanfordalumni.org
The Journal of Urology
|May 20, 2009
Summary
Bladder injury during laparoscopic orchiopexy is rare but serious. Management can involve open or laparoscopic repair, with specific preventative measures recommended.
Area of Science:
- Pediatric Surgery
- Urology
Background:
- Laparoscopic orchiopexy is a standard procedure for undescended testes.
- Creation of the transperitoneal tunnel poses a risk of bladder injury.
Purpose of the Study:
- To review the incidence and management of bladder injuries during laparoscopic orchiopexy.
- To identify strategies for preventing this complication.
Main Methods:
- Retrospective review of operative notes for laparoscopic orchiopexies performed between August 2002 and October 2008.
- Identification and analysis of cases with bladder injuries and their subsequent treatment.
Main Results:
- Three bladder injuries occurred in 101 laparoscopic orchiopexies (3%).
- Injuries were recognized intraoperatively or postoperatively and managed with open or laparoscopic repair.
Conclusions:
- Bladder injury is a rare but significant complication of laparoscopic orchiopexy.
- Management can be achieved through open or laparoscopic approaches.
- Recommendations include bladder drainage, careful dissection, and heightened suspicion for hematuria.