[Ultrasonography-guided transrectal perineal drainage of retroanastomotic collections in orthotopic neobladder].

Pelvic collections are not an uncommon complication of pelvic surgery. Usually, such a complications are managed by TC-guided percutaneous drainage or even by more invasive surgical operations. Here, we describe a transperineal TRUS-guided drainage technique of pelvic urinomas occurring after a radical cystectomy (RC) for invasive Bladder Cancer (BC) in two patients, respectively 55 and 77 YOM. Respectively, 10 and 20 days after catheter had been taken out patients began complaining a severe pelvic pain associated to fever (over 40 degrees C). Physical examination and an ultrasound, followed by a CT-scan, showed a huge retroanastomotic pelvic urinoma (width over 10 cm). CT-guided percutaneous drainage was considered at increased risk of iatrogenic injury of mesenterial neobladder because of its location. A TRUS-guided percutaneous perineal drainage of urinomas with a pig-tail 8 ch was carried out. Urinomas were successfully drained and no significant complications were encountered. At a median follow-up of 11 months no late complications were found. Our preliminary experience with this procedure is favourable regarding mininvasivity, lack of complications and its feasibility by urologists themselves. Its impact on cost/benefit rate is favorable too. We believe that this technique might be considered as an alternative to CT-guided percutaneous drainage.