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Iatrogenic direct rectal injury: An unusual complication during suprapubic cystostomy (SPC) insertion and its laparoscopic management

Rakesh Rajmohan, Bernardo Aguilar-Davidov, Theodoros Tokas, Jens Rassweiler, Ali Serdar Gözen
  • Rakesh Rajmohan
    Department of Urology, SLK-Kliniken, University of Heidelberg, Heilbronn, Germany
  • Bernardo Aguilar-Davidov
    Department of Urology, SLK-Kliniken, University of Heidelberg, Heilbronn, Germany
  • Theodoros Tokas
    Department of Urology, SLK-Kliniken, University of Heidelberg, Heilbronn, Germany
  • Jens Rassweiler
    Department of Urology, SLK-Kliniken, University of Heidelberg, Heilbronn, Germany
  • Ali Serdar Gözen
    Department of Urology, SLK-Kliniken, University of Heidelberg, Heilbronn, Germany | asgozen@yahoo.com

Abstract

Suprapubic cystostomy (SPC) is commonly used, instead of indwelling urethral catheter- ization, as indicated in many pathological conditions. Although considered to be a safe procedure that can be easily performed in an outpatient basis several complications have been reported in international literature. Bowel injury can be a serious complication with the small intestine affected in the majority of cases. We present a case of an acci- dental rectal injury by a suprapubic catheter misplacement, in a 76 year old demented patient with prostatic hyperplasia and chronic urinary retention. The injury was confirmed by cystogra- phy and injection of contrast meterial through the suprapubic catheter, and successfully treated laparoscopically by an extraperitoneal approach. The patient was discharged after 10 days with- out any complications. The above method, in experienced hands, can be an effective primary treatment option for such rare but devastating complications. The case and management is unique as, to our knowledge, as no similar cases have been presented.

Keywords

Suprapubic cystostomy (SPC); Ultrasonography (USG); Benign prostatic hyperplasia (BPH)

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Submitted: 2013-06-24 17:32:07
Published: 2013-06-24 00:00:00
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Copyright (c) 2013 Rakesh Rajmohan, Bernardo Aguilar-Davidov, Theodoros Tokas, Jens Rassweiler, Ali Serdar Gözen

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