1) To review the multi-modality imaging features of post operative urological complications. 2) To learn the value of excretory CT urography in identifying the presence of urinary extravasation. 3) To explore the various interventional radiology techniques used to provide urinary diversion with discussion of pearls and pitfalls.
Complications in the early post-operative period following urological surgery are common,
particularly with high risk procedures such as robotic assisted cystectomy. Clinical symptoms and signs to suggest complications include: Abdominal pain and signs of peritonism Tachycardia and increased respiratory rate Pyrexia and raised inflammatory markers (white cell count and CRP) Excessive output from surgical drains (particularly with high creatinine content) Prolonged paralytic ileus Unusually...
Findings and procedure details
We present a range of interesting cases whichdemonstrate the key CT imaging features of urological complications and discuss the importance of interventional radiology in such management. Early CT imaging is essential to assess: Size and location of any abdomino-pelvic collections Contrast extravasation on excretory phase suggesting anastamotic leak or bladder perforation Hydroureteronephrosis Evidence of active haemorrhage requiring prompt arterial embolisation or surgical intervention Small...
Recognition and early imaging of post-operative urologic complications is essential to allow appropriate interventional radiology management.
Close collabaritive working is required between the urology and interventional radiology teams. Excretory phase Ct urography is very reliable in detecting urine leak. Urinary diversion can be achieved either by percutaneous nephrostomy or placement of retrograde ureteric stents via an ileal conduit as described. Image guided drainage of infected...