Laparoscopic excision of prostatic utricles in children

Citation
Ck. Yeung et al., Laparoscopic excision of prostatic utricles in children, BJU INT, 87(6), 2001, pp. 505-508
Citations number
16
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Urology & Nephrology
Journal title
BJU INTERNATIONAL
ISSN journal
1464-4096 → ACNP
Volume
87
Issue
6
Year of publication
2001
Pages
505 - 508
Database
ISI
SICI code
1464-4096(200104)87:6<505:LEOPUI>2.0.ZU;2-C
Abstract
Objective To report our experience of laparoscopic excision of symptomatic prostatic utricles in children. Patients and methods Prostatic utricles were excised laparoscopically in fo ur boys (mean age 6.3 years, range 1.5-17). Cysto-urethroscopy and cannulat ion of the prostatic utricle was initially undertaken with a cystoscope tha t was left in situ inside the prostatic utricle to facilitate subsequent id entification and mobilization during the laparoscopic procedure. Laparoscop y was conducted via a 5-mm port inserted through a supra-umbilical incision , Two more 5 mm working ports were inserted at the right and left mid-abdom en. The prostatic utricle was easily identified with the guidance of cystos copic transillumination. Dissection was further facilitated by lifting and counter-traction of the prostatic utricle using the indwelling cystoscope. The prostatic utricle was completely mobilized and divided at its confluenc e with the urethra using an ultrasonic scalpel. Results Laparoscopic excision of the prostatic utricle was successful in al l four patients. The urethral defect was closed by intracorporeal suturing in three patients while the defect was small enough to be adequately closed by ultrasonic coagulation in one. One patient also had a nonfunctioning dy splastic kidney associated with an ectopic ureter joining into the prostati c utricle, and underwent nephroureterectomy at the same setting. The mean ( range) operative duration was 148 (105-225) min, All four patients recovere d uneventfully with no complications. Conclusions Laparoscopic excision under cystoscopic guidance is effective f or symptomatic prostatic utricles, offering a good surgical view and allowi ng easy dissection in a deep and narrow pelvic cavity.