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Ces Urol 2015; 19(3): 185–187
VIDEO
As a part of the preoperative examination 3D CT
cystography or better CT IVU (for better imagining
of the relationship between ureters and diverticu‑
lum) were used
Results
: 9 men, aged 670±51 (573 to 751)
years BMI 28 3±41 (23 0 to 35 0) Prostate volume
measured by transabdominal sonography was
43 4±14 2 (30–80) ml PSA 2 7±1 8 (0 5 to 6 5) ng /
ml The procedure was carried out under general
anaesthesia in endoscopic (lithotomy) position
No routine antibiotic prophylaxis PVP was per‑
formed, in the first case by Green Light Laser® HPS
and 7x by XPS Green Light Laser (cooled MOXY®
fibre) Delivered energy by PVP was 1916±1073
(84–458) kJ At the end of endoscopy stenting of
the ureter on the side of the diverticulum (or both
ureters according to localization the diverticulum)
was performed The patient was re‑positioned to
Trendelenburg Laparoscopic diverticulectomy was
performed using 4 ports (2x5 and 2x10 mm) by
extravesical transperineal approach The size of the
diverticulumwas 615±19 8 (26–90) mm The mean
time of operation was 166 5±44 7 (90–255) Ure‑
teral catheter was removed first day after surgery,
bladder catheter the sixth postoperative day No
postoperative complications were observed The
first patient underwent TUR incision for sclerosis of
bladder neck after one year
Conclusion
: Resolution of subvesical obstruc‑
tion with urinary bladder diverticulectomy is not
a common procedure in daily practice The com‑
bination of PVP and LD is a modern minimally
invasive method We currently intend to give it
a clear preference in clinical practice to the other
methods It is only isadvantageous from the point
of financing using our DRG system, which is more
profitable with a two stage procedure
KEY WORDS
Urinary bladder diverticulum, laparoscopy, BPH,
photoselective vaporization, green light laser
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