Noninvasive treatment of intraperitoneal urinary system perforations with percutaneous placement of a peritoneal drainage catheter

Abstract

Background/aim: : Intraperitoneal urinary system perforation is a rare but serious complication of endoscopic urologic surgery.Percutaneous placement of a peritoneal drainage catheter is already mainly used for diagnostic purposes. We present our experiencewith percutaneous drainage catheters for conservative management of intraperitoneal urinary system perforations occurring duringendoscopic urologic surgery with close monitorization in selected cases.Materials and methods: Urinary system perforations had developed in 21 (0.8%) of 2603 patients undergoing endoscopic urologicsurgery at our department in 2014–2016. The perforation was intraperitoneal in only 5 (0.19) of all the patients. A percutaneousperitoneal drainage catheter with the guidance of ultrasonography was placed in four of the patients.Results: Conservative management by draining excess fluid with a drainage catheter percutaneously placed under close monitorizationwas successful in four out of five patients with urinary system perforation occurring during endoscopic urologic surgery. The remainingpatient was treated successfully with open laparotomy because of fulminant evidence of peritonitis.Conclusion: Our findings and experience may suggest that conservative management of intraperitoneal urinary system perforationsoccurring during endoscopic urologic surgery by percutaneous drainage catheter under close monitorization is feasible in carefullyselected patients.