Migration of Hem-o-Lok clips into the bladder after radical prostatectomy – own experience
- Authors: Bogomolov O.A.1, Sukhanova T.V.1, Shkolnik M.I.1, Kneev A.Y.1, Dolbov A.L.1, Artemov М.V.1
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Affiliations:
- Russian Research Center for Radiology and Surgical Technologies named after academician A.M. Granov
- Issue: Vol 41, No 2 (2024)
- Pages: 130-135
- Section: Clinical case
- URL: https://journals.rcsi.science/PMJ/article/view/257655
- DOI: https://doi.org/10.17816/pmj412130-135
- ID: 257655
Cite item
Abstract
Non-absorbable polymer Hem-o-Lok clips are widely used during nerve-sparing radical prostatectomy for clipping of the neurovascular bundle, as well as for rapid knotless fixation of sutures during the formation of urethrovesical anastomosis. At the same time, cases of migration of Hem-o-Lok clips into the bladder at various times after RP have been described.
Our retrospective analysis of 1321 patients, who underwent laparoscopic radical prostatectomy at A.M. Granov Russian Scientific Center of Radiology and Surgical Technologies from 2014 to 2023, revealed 3 cases of Hem-o-Lok clip intravesical migration. Also, to search for similar cases of this rare complication a literature review was conducted.
The frequency of postoperative intra-bladder clip migration in our study was 0.23 % (3/1321). One case of spontaneous clip passage was observed 3 months later the radical prostatectomy. In two other cases, long-term symptoms of dysuria (in 7 months and 4 years, respectively) revealed clip incrustation, which led to the removal of the clips through endoscopic intervention and laser cystolithotripsy.
Despite the low incidence of this complication, the use of Hem-o-Lok clips during laparoscopic radical prostatectomy, should be minimized reasonably, particularly during the urethro-vesical anastomosis formation. If lower urinary tract symptoms and/or hematuria occur at any point in the postoperative period, it’s advisable to conduct an instrumental examination of the bladder to rule out potential clip migration and possible incrustation.
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##article.viewOnOriginalSite##About the authors
O. A. Bogomolov
Russian Research Center for Radiology and Surgical Technologies named after academician A.M. Granov
Email: urologbogomolov@gmail.com
ORCID iD: 0000-0002-5860-9076
SPIN-code: 6554-4775
Candidate of Medical Sciences, Associate Professor of the Department of Radiology, Surgery and Oncology, Senior Researcher
Russian Federation, Saint PetersburgT. V. Sukhanova
Russian Research Center for Radiology and Surgical Technologies named after academician A.M. Granov
Email: tamara.sukhanova00@mail.ru
ORCID iD: 0000-0002-2548-0149
SPIN-code: 9513-0818
Postgraduate Student of the Department of Radiology, Surgery and Oncology
Russian Federation, Saint PetersburgM. I. Shkolnik
Russian Research Center for Radiology and Surgical Technologies named after academician A.M. Granov
Email: shkolnik_phd@mail.ru
ORCID iD: 0000-0003-0589-7999
SPIN-code: 4743-9236
MD, PhD, Associate Professor, Professor of the Department of Radiology, Surgery and Oncology, Senior Researcher
Russian Federation, Saint PetersburgA. Yu. Kneev
Russian Research Center for Radiology and Surgical Technologies named after academician A.M. Granov
Email: alexmedspb@gmail.com
ORCID iD: 0000-0002-5899-8905
SPIN-code: 8015-1529
Candidate of Medical Sciences, Assistant of the Department of Radiology, Surgery and Oncology
Russian Federation, Saint PetersburgA. L. Dolbov
Russian Research Center for Radiology and Surgical Technologies named after academician A.M. Granov
Email: art.dolbov@yandex.ru
ORCID iD: 0000-0002-2195-2401
SPIN-code: 6447-7663
Scopus Author ID: 57203140829
Radiologist, Junior Researcher of the Laboratory of Theranostics of Oncological Diseases
Russian Federation, Saint PetersburgМ. V. Artemov
Russian Research Center for Radiology and Surgical Technologies named after academician A.M. Granov
Author for correspondence.
Email: tamara.sukhanova00@mail.ru
ORCID iD: 0009-0007-1229-1203
SPIN-code: 1525-7663
Candidate of Medical Sciences, Head of the Department of Magnetic Resonance Imaging, Radiologist
Russian Federation, Saint PetersburgReferences
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