An Alternative Approach to Managing Urethrovesical Anastomotic Leakage After Robot-Assisted Laparoscopic Radical Prostatectomy: External Urethral Meatus Catheter Fixation

A 46-year-old male presented with a prostate-specific antigen (PSA) level of 4.27 ng/mL. MRI identified a Prostate Imaging Reporting and Data System category 4 lesion in the right peripheral zone. Prostate biopsy confirmed adenocarcinoma with a Gleason score of 3+3. The patient was diagnosed with localized prostate cancer (cT2aN0M0) and underwent robot-assisted laparoscopic radical prostatectomy via a transperitoneal approach. Postoperatively, urine was immediately observed through the intraperitoneal drain. To address the anastomotic urinary leakage (AUL), gentle traction of the urethral catheter was applied and secured with abdominal tape. However, on postoperative day 8, the patient developed severe abdominal pain. A CT scan revealed fluid accumulation around the bladder, liver, and spleen, along with ventral migration of the drain, indicating inadequate urine drainage. Standard AUL management strategies had proven ineffective, complicating the case. Ultimately, fixation of the urethral catheter at the external urethral meatus using adhesive tape successfully resolved the leakage and alleviated the abdominal pain. This simple technique may offer an effective alternative for managing AUL.