Robotic excision of vaginal pouch in ovotesticular disorder of sexual development
ABSTRACT Purpose: Ovotesticular disorder of sexual development (DSD) is the rarest of DSDs with an incidence of 1:20000 (1). Management of vaginal pouches in such cases is warranted for symptomatic presentations and laparoscopy is considered the gold standard treatment (2). We report a rare case of...
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| Format: | Article |
| Language: | English |
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Sociedade Brasileira de Urologia
2022-11-01
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| Series: | International Brazilian Journal of Urology |
| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1677-55382022000600994&tlng=en |
| _version_ | 1828093678705442816 |
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| author | Prashant Singh Sanjay Kumar Sridhar Panaiyadiyan Prem Nath Dogra |
| author_facet | Prashant Singh Sanjay Kumar Sridhar Panaiyadiyan Prem Nath Dogra |
| author_sort | Prashant Singh |
| collection | DOAJ |
| description | ABSTRACT Purpose: Ovotesticular disorder of sexual development (DSD) is the rarest of DSDs with an incidence of 1:20000 (1). Management of vaginal pouches in such cases is warranted for symptomatic presentations and laparoscopy is considered the gold standard treatment (2). We report a rare case of robotic excision of a large symptomatic vaginal pouch in a 19-year-old boy with ovotesticular DSD. Material and Methods: A 19-year-old boy with ovotesticular DSD post hypospadias repair in early childhood presented with complaints of recurrent UTIs, ballooning of urethra during micturition and post-void dribbling. Ultrasound, voiding cystourethrogram (VCUG) and magnetic resonance imaging (MRI) were suggestive of a vaginal pouch. The patient underwent endo-evaluation followed by robot-assisted excision of the vaginal pouch. Endo-evaluation showed two orifices in the posterior urethra. The posterior orifice was leading into a blind-ending rudimentary uterus and the true urethra was lying anteriorly. The DaVinci Xi Robotic Surgical System was used and the entire pouch was dissected free of the surrounding tissues using monopolar scissors. The pouch was transected just a few millimetres from its junction with the urethra. The urethra was then closed with V-loc 4-0 suture. The patient was discharged on postoperative day 2 and the catheter was removed on day 21. Results: Follow-up VCUG at 6 weeks did not show any residual pouch. There was no complaint of post-void dribbling or UTI at 30 months of follow-up. Conclusion: Robot-assisted laparoscopy should be considered as an alternative to laparoscopy for the primary treatment of a large symptomatic vaginal pouch. |
| first_indexed | 2024-04-11T06:47:21Z |
| format | Article |
| id | doaj.art-b2fedc587e9c4e27a06487cca58c153d |
| institution | Directory Open Access Journal |
| issn | 1677-6119 |
| language | English |
| last_indexed | 2024-04-11T06:47:21Z |
| publishDate | 2022-11-01 |
| publisher | Sociedade Brasileira de Urologia |
| record_format | Article |
| series | International Brazilian Journal of Urology |
| spelling | doaj.art-b2fedc587e9c4e27a06487cca58c153d2022-12-22T04:39:19ZengSociedade Brasileira de UrologiaInternational Brazilian Journal of Urology1677-61192022-11-0148699499510.1590/s1677-5538.ibju.2022.0038Robotic excision of vaginal pouch in ovotesticular disorder of sexual developmentPrashant SinghSanjay Kumarhttps://orcid.org/0000-0003-3912-3967Sridhar PanaiyadiyanPrem Nath DograABSTRACT Purpose: Ovotesticular disorder of sexual development (DSD) is the rarest of DSDs with an incidence of 1:20000 (1). Management of vaginal pouches in such cases is warranted for symptomatic presentations and laparoscopy is considered the gold standard treatment (2). We report a rare case of robotic excision of a large symptomatic vaginal pouch in a 19-year-old boy with ovotesticular DSD. Material and Methods: A 19-year-old boy with ovotesticular DSD post hypospadias repair in early childhood presented with complaints of recurrent UTIs, ballooning of urethra during micturition and post-void dribbling. Ultrasound, voiding cystourethrogram (VCUG) and magnetic resonance imaging (MRI) were suggestive of a vaginal pouch. The patient underwent endo-evaluation followed by robot-assisted excision of the vaginal pouch. Endo-evaluation showed two orifices in the posterior urethra. The posterior orifice was leading into a blind-ending rudimentary uterus and the true urethra was lying anteriorly. The DaVinci Xi Robotic Surgical System was used and the entire pouch was dissected free of the surrounding tissues using monopolar scissors. The pouch was transected just a few millimetres from its junction with the urethra. The urethra was then closed with V-loc 4-0 suture. The patient was discharged on postoperative day 2 and the catheter was removed on day 21. Results: Follow-up VCUG at 6 weeks did not show any residual pouch. There was no complaint of post-void dribbling or UTI at 30 months of follow-up. Conclusion: Robot-assisted laparoscopy should be considered as an alternative to laparoscopy for the primary treatment of a large symptomatic vaginal pouch.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1677-55382022000600994&tlng=en |
| spellingShingle | Prashant Singh Sanjay Kumar Sridhar Panaiyadiyan Prem Nath Dogra Robotic excision of vaginal pouch in ovotesticular disorder of sexual development International Brazilian Journal of Urology |
| title | Robotic excision of vaginal pouch in ovotesticular disorder of sexual development |
| title_full | Robotic excision of vaginal pouch in ovotesticular disorder of sexual development |
| title_fullStr | Robotic excision of vaginal pouch in ovotesticular disorder of sexual development |
| title_full_unstemmed | Robotic excision of vaginal pouch in ovotesticular disorder of sexual development |
| title_short | Robotic excision of vaginal pouch in ovotesticular disorder of sexual development |
| title_sort | robotic excision of vaginal pouch in ovotesticular disorder of sexual development |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1677-55382022000600994&tlng=en |
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