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Robotic assisted retrovesical approach to prostatic utricle excision and other complex pelvic pathology in children is safe and feasible.
J Pediatr Urol. 2021 Oct; 17(5):710-715.JP

Abstract

INTRODUCTION

Excision of the prostatic utricle has been a challenging surgical problem due to the location deep in the pelvis between the rectum and bladder. Robotic-assisted laparoscopic surgery allows minimally invasive access to this location.

OBJECTIVE

To describe the robotic surgical outcomes and important techniques associated with robotic excision of the prostatic utricle and explain how these techniques apply to similar pediatric pelvic pathology.

STUDY DESIGN

Retrospective chart evaluation of patients treated at a single institution with robotic excision of a prostatic utricle as well as two other patients in which the similar approach was employed.

RESULTS

4 patients underwent robotic excision of a prostatic utricle. A fifth patient underwent excision of urethral diverticulum that was the remnant of an ectopic ureter. The sixth patient had a high urogenital sinus that required laparoscopic assisted vaginoplasty approached in a similar manner to the above listed cases. Mean age at surgery was 35.5 months for the utricle patients. Mean follow-up duration for the utricle patients was 30.75 months. Average hospital stay for the utricle patients was one day. In the utricle patients one patient developed transient urinary retention and one had a postoperative urinary tract infection. Concomitant cystoscopy used in the two non-utricle patients was a key step in defining the proper location of dissection.

DISCUSSION

Robotic-assisted laparoscopic retrovesical excision of the prostatic utricle is a safe operation that requires a skill set that can be readily applied to other complex pelvic pathology such as the ectopic ureter, urethral diverticulum, and urogenital sinus. Concomitant cystoscopy can aid significantly in defining the location and limits of dissection.

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Publisher Full Text (DOI)

Authors+Show Affiliations

Bayne AP
Oregon Health and Science University, Portland, OR, USA. Electronic address: baynea@ohsu.edu.
Austin JC
Oregon Health and Science University, Portland, OR, USA.
Seideman CA
Oregon Health and Science University, Portland, OR, USA.

MeSH

ChildHumansLaparoscopyMalePelvisRetrospective StudiesRobotic Surgical ProceduresSaccule and UtricleUrethra

Pub Type(s)

Journal Article

Language

eng

PubMed ID

34511376

Citation

Bayne, Aaron P., et al. "Robotic Assisted Retrovesical Approach to Prostatic Utricle Excision and Other Complex Pelvic Pathology in Children Is Safe and Feasible." Journal of Pediatric Urology, vol. 17, no. 5, 2021, pp. 710-715.
Bayne AP, Austin JC, Seideman CA. Robotic assisted retrovesical approach to prostatic utricle excision and other complex pelvic pathology in children is safe and feasible. J Pediatr Urol. 2021;17(5):710-715.
Bayne, A. P., Austin, J. C., & Seideman, C. A. (2021). Robotic assisted retrovesical approach to prostatic utricle excision and other complex pelvic pathology in children is safe and feasible. Journal of Pediatric Urology, 17(5), 710-715. https://doi.org/10.1016/j.jpurol.2021.08.004
Bayne AP, Austin JC, Seideman CA. Robotic Assisted Retrovesical Approach to Prostatic Utricle Excision and Other Complex Pelvic Pathology in Children Is Safe and Feasible. J Pediatr Urol. 2021;17(5):710-715. PubMed PMID: 34511376.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Robotic assisted retrovesical approach to prostatic utricle excision and other complex pelvic pathology in children is safe and feasible. AU - Bayne,Aaron P, AU - Austin,J Christopher, AU - Seideman,Casey A, Y1 - 2021/08/17/ PY - 2021/05/04/received PY - 2021/07/29/revised PY - 2021/08/06/accepted PY - 2021/9/14/pubmed PY - 2021/11/17/medline PY - 2021/9/13/entrez KW - Ectopic ureter KW - Robot KW - Urogenital sinus KW - Utricle SP - 710 EP - 715 JF - Journal of pediatric urology JO - J Pediatr Urol VL - 17 IS - 5 N2 - INTRODUCTION: Excision of the prostatic utricle has been a challenging surgical problem due to the location deep in the pelvis between the rectum and bladder. Robotic-assisted laparoscopic surgery allows minimally invasive access to this location. OBJECTIVE: To describe the robotic surgical outcomes and important techniques associated with robotic excision of the prostatic utricle and explain how these techniques apply to similar pediatric pelvic pathology. STUDY DESIGN: Retrospective chart evaluation of patients treated at a single institution with robotic excision of a prostatic utricle as well as two other patients in which the similar approach was employed. RESULTS: 4 patients underwent robotic excision of a prostatic utricle. A fifth patient underwent excision of urethral diverticulum that was the remnant of an ectopic ureter. The sixth patient had a high urogenital sinus that required laparoscopic assisted vaginoplasty approached in a similar manner to the above listed cases. Mean age at surgery was 35.5 months for the utricle patients. Mean follow-up duration for the utricle patients was 30.75 months. Average hospital stay for the utricle patients was one day. In the utricle patients one patient developed transient urinary retention and one had a postoperative urinary tract infection. Concomitant cystoscopy used in the two non-utricle patients was a key step in defining the proper location of dissection. DISCUSSION: Robotic-assisted laparoscopic retrovesical excision of the prostatic utricle is a safe operation that requires a skill set that can be readily applied to other complex pelvic pathology such as the ectopic ureter, urethral diverticulum, and urogenital sinus. Concomitant cystoscopy can aid significantly in defining the location and limits of dissection. SN - 1873-4898 UR - https://www.unboundmedicine.com/medline/citation/34511376/Robotic_assisted_retrovesical_approach_to_prostatic_utricle_excision_and_other_complex_pelvic_pathology_in_children_is_safe_and_feasible_ DB - PRIME DP - Unbound Medicine ER -