Migration of Hem-o-Lok clips into the bladder after radical prostatectomy – own experience

O. A. Bogomolov; T. V. Sukhanova; M. I. Shkolnik; A. Yu. Kneev; A. L. Dolbov; М. V. Artemov

doi:10.17816/pmj412130-135

Perm Medical Journal ›› 2024, Vol. 41 ›› Issue (2) :130 -135. DOI: 10.17816/pmj412130-135

Clinical case

research-article

Migration of Hem-o-Lok clips into the bladder after radical prostatectomy – own experience

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Russian Research Center for Radiology and Surgical Technologies named after academician A.M. Granov

Candidate of Medical Sciences, Associate Professor of the Department of Radiology, Surgery and Oncology, Senior Researcher

Postgraduate Student of the Department of Radiology, Surgery and Oncology

MD, PhD, Associate Professor, Professor of the Department of Radiology, Surgery and Oncology, Senior Researcher

Candidate of Medical Sciences, Assistant of the Department of Radiology, Surgery and Oncology

Radiologist, Junior Researcher of the Laboratory of Theranostics of Oncological Diseases

Candidate of Medical Sciences, Head of the Department of Magnetic Resonance Imaging, Radiologist

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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.

Keywords

laparoscopic radical prostatectomy / Hem-o-lok clip migration

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O. A. Bogomolov, T. V. Sukhanova, M. I. Shkolnik, A. Yu. Kneev, A. L. Dolbov, М. V. Artemov. Migration of Hem-o-Lok clips into the bladder after radical prostatectomy – own experience. Perm Medical Journal, 2024, 41(2): 130-135 DOI:10.17816/pmj412130-135

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References

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[1]	Chen B.H., Tseng J.S., Chiu A.W. Bladder Neck Contracture with Hem-o-Lok Clips Migration after Robotic-Assisted Radical Prostatectomy: A Case Report and Literature Review. Urol Int. 2022; 106 (9): 970–973. DOI: 10.1159/000521152. Epub 2022 Jan 3. PMID: 34979514.

[2]

Singh A., Sharma R., Agrawal A., Surwase P.P., Patil A., Batra R., Ganpule A., Sabnis R., Desai M. Outcomes of Hem-o-Lok clip migration at vesico-urethral anastomotic site post-robotic-assisted laparoscopic radical prostatectomy: a single centre experience. Int Urol Nephrol. 2023; 55 (6): 1467–1475. DOI: 10.1007/s11255-023-03554-9. Epub 2023 Mar 28. PMID: 36976419.

[3]	Ohyama T., Shimbo M., Endo F., Hattori K. Late-onset Hem-o-Lok® migration into the bladder after robot-assisted radical prostatectomy. IJU Case Rep. 2021 Nov 11; 5 (1): 49–52. DOI: 10.1002/iju5.12386. PMID: 35005473; PMCID: PMC8720733.

[4]	Nistiana A., Pramod S.V., Safriadi F. Type II Hem-o-lok clip migration and stone formation in robot assisted laparoscopic prostatectomy patient: A case report and serial cases review. Urol Case Rep. 2022; 43: 102073. DOI: 10.1016/j.eucr.2022.102073. PMID: 35463919; PMCID: PMC9020103.

[5]	Deen S., Rehman O., Lunawat R., Tasleem A. Stone Formation Due to Migration of Hemostatic Clip After Robot-Assisted Laparoscopic Radical Prostatectomy: A Late and Rare Presentation. Cureus. 2022; 14 (10): e30922. DOI: 10.7759/cureus.30922. PMID: 36465783; PMCID: PMC9710727.

[6]

Zhou H., Li Y., Li G., Liang G., Zhao Z., Luo X., Chen S. Hem-o-Lok clip migration into renal pelvis and stone formation as a long-term complication following laparoscopic pyelolithotomy: a case report and literature review. BMC Urol. 2022; 22 (1): 66. DOI: 10.1186/s12894-022-01015-6. PMID: 35440078; PMCID: PMC9016957.

[7]

Кызласов П.С., Колпациниди Ф.Г., Казанцев Д.В. и др. Формирование конкремента в мочевом пузыре в результате миграции клипсы Hem-o-lok после робот-ассистированной радикальной простатэктомии. Экспериментальная и клиническая урология 2021; 14 (3): 70–72. DOI: 10.29188/2222-8543-2021-14-3-70-72. EDN WXUGIP / Kyzlasov P.S., Kolpacinidi F.G., Kazancev D.V. i dr. Formirovanie konkrementa v mochevom puzyre v rezul'tate migracii klipsy Hem-o-lok posle robot-assistirovannoj radikal'noj prostatektomii. Eksperimental'naya i klinicheskaya urologiya 2021; 14 (3): 70–72. DOI: 10.29188/2222-8543-2021-14-3-70-72. EDN WXUGIP (in Russian).

[8]	Yu C.C., Yang C.K., Ou Y.C. Three Types of Intravesical Hem-o-Lok Clip Migration After Laparoscopic Radical Prostatectomy. J Laparoendosc Adv Surg Tech A. 2015; 25 (12): 1005–8. DOI: 10.1089/lap.2015.0150. Epub 2015 Nov 13. PMID: 26566082.

[9]	Van Velthoven R.F., Ahlering T.E., Peltier A., Skarecky D.W., Clayman R.V. Technique for laparoscopic running urethrovesical anastomosis: the single knot method. Urology. 2003; 61 (4): 699–702. DOI: 10.1016/s0090-4295(02)02543-8.