Urethrovesicular anastomotic leak post radical prostatectomy

Case contributed by Dr Henry Knipe

Presentation

Three weeks post radical prostatectomy ?leak.

Patient Data

Age: 60 years
Gender: Male

Contrast leak from the presumed site of anastomosis at the prostatic urethra/bladder neck, which is persistent on post bladder emptying views. It appears to be extraperitoneal.     

Case Discussion

  • urethrovesicular anastomotic leakage (UVAL) post radical prostatectomy can present as an early or late complication and is one of the most common complications but with a decreasing incidence over time:
    • ~80% on day 8 post-operatively
    • ~40% on day 11 post-operatively
    • 20% on day 14 post-operatively
    • 8% on day 21 post-operatively
  • UVAL can result in extra- or intraperitoneal urine collections, the latter being more serious and can result in peritonitis, ileus or renal failure

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