Uro-oncology
Diagnostic and extirpative surgery for renal, urothelial, prostate, testicular and penile cancer.
Ileal conduit urinary diversion
Ureteroileal leak
Ischaemia, tension or anastomotic failure can produce urinary leakage, collection and infection.
Applies to: Bricker separate ureteroileal anastomoses · Wallace common-plate anastomosis · Intracorporeal ileal conduit · Extracorporeal ileal conduitUreteroileal stricture and upper-tract obstruction
Ischaemia, scarring or recurrence can narrow an anastomosis and threaten renal drainage.
Applies to: Bricker separate ureteroileal anastomoses · Wallace common-plate anastomosis · Intracorporeal ileal conduit · Extracorporeal ileal conduitBowel leak, ileus or obstruction
Bowel isolation and re-anastomosis can fail or lead to delayed gastrointestinal recovery and adhesive obstruction.
Applies to: Bricker separate ureteroileal anastomoses · Wallace common-plate anastomosis · Intracorporeal ileal conduit · Extracorporeal ileal conduitUrinary, intra-abdominal or wound infection
Urine, bowel and abdominal wounds create overlapping infection sources.
Applies to: Bricker separate ureteroileal anastomoses · Wallace common-plate anastomosis · Intracorporeal ileal conduit · Extracorporeal ileal conduitStoma ischaemia, retraction or mucocutaneous separation
Mesenteric tension, poor perfusion or abdominal-wall geometry can compromise early stoma healing and appliance fit.
Applies to: Bricker separate ureteroileal anastomoses · Wallace common-plate anastomosis · Intracorporeal ileal conduit · Extracorporeal ileal conduitParastomal hernia, prolapse or stenosis
The abdominal-wall conduit aperture can enlarge, narrow or permit bowel herniation over time.
Applies to: Bricker separate ureteroileal anastomoses · Wallace common-plate anastomosis · Intracorporeal ileal conduit · Extracorporeal ileal conduitMetabolic, renal or nutritional consequences
Urine contact with bowel and altered bowel length can contribute to electrolyte, acid-base, renal and nutritional problems.
Applies to: Bricker separate ureteroileal anastomoses · Wallace common-plate anastomosis · Intracorporeal ileal conduit · Extracorporeal ileal conduitConduit or upper-tract stones
Mucus, infection, foreign material and impaired drainage can promote calculus formation.
Applies to: Bricker separate ureteroileal anastomoses · Wallace common-plate anastomosis · Intracorporeal ileal conduit · Extracorporeal ileal conduitCommon-plate obstruction affecting both kidneys
A problem at the shared anastomosis can compromise bilateral drainage rather than one ureter alone.
Applies to: Wallace common-plate anastomosisExtravasation with chemical tissue injury
Instillation through a perforated bladder or misplaced catheter can expose perivesical tissues to a cytotoxic agent and cause severe local injury.
Applies to: Recovery-area immediate instillation · Theatre immediate instillation · Closed-system intravesical deliveryChemical cystitis, urgency or pain
Urothelial irritation can cause dysuria, frequency, urgency, bladder spasm and pelvic pain.
Applies to: Recovery-area immediate instillation · Theatre immediate instillation · Closed-system intravesical deliveryHaematuria or clot-related drainage failure
A bleeding resection bed may worsen symptoms, block the catheter and complicate safe agent removal.
Applies to: Recovery-area immediate instillation · Theatre immediate instillation · Closed-system intravesical deliveryUrinary infection
Instrumentation and catheter manipulation can contribute to infection after TURBT.
Applies to: Recovery-area immediate instillation · Theatre immediate instillation · Closed-system intravesical deliverySystemic or hypersensitivity reaction
Unexpected absorption or agent sensitivity may produce systemic symptoms requiring recognition beyond routine bladder discomfort.
Applies to: Recovery-area immediate instillation · Theatre immediate instillation · Closed-system intravesical deliveryOccupational or environmental exposure
Leaks, disconnections and unsafe disposal can expose staff, carers or the environment to cytotoxic material.
Applies to: Recovery-area immediate instillation · Theatre immediate instillation · Closed-system intravesical deliveryWrong-patient, wrong-agent or protocol deviation
A selection, identification, timing or documentation failure can create direct harm and undermine the intended oncological pathway.
Applies to: Recovery-area immediate instillation · Theatre immediate instillation · Closed-system intravesical deliveryIntravesical BCG therapy
BCG cystitis and severe lower-tract symptoms
Immune-mediated bladder inflammation can cause dysuria, frequency, urgency, haematuria and pain that may limit treatment.
Applies to: BCG induction course · BCG maintenance course · Risk-adapted modified BCG pathwaySystemic BCG infection or inflammatory syndrome
Live organisms or an intense systemic response can cause persistent fever, organ involvement and critical illness, sometimes after a delay.
Applies to: BCG induction course · BCG maintenance course · Risk-adapted modified BCG pathwayTraumatic catheterisation with systemic exposure
Urethral or bladder trauma can permit BCG access to the bloodstream and is a key procedural safety concern.
Applies to: BCG induction course · BCG maintenance course · Risk-adapted modified BCG pathwayUrinary bacterial infection
Catheterisation and overlapping urinary symptoms can create or mask a conventional urinary infection.
Applies to: BCG induction course · BCG maintenance course · Risk-adapted modified BCG pathwayGranulomatous prostatitis, epididymo-orchitis or upper-tract involvement
Local or ascending BCG-related disease may present in genital, prostatic or upper urinary tract sites.
Applies to: BCG induction course · BCG maintenance course · Risk-adapted modified BCG pathwayBladder contracture or reduced capacity
Severe or repeated inflammation can cause fibrosis and a persistently small, painful bladder.
Applies to: BCG induction course · BCG maintenance course · Risk-adapted modified BCG pathwayTreatment interruption or incomplete oncological course
Toxicity, access or pathway deviations may prevent intended treatment and require a revised cancer-control strategy.
Applies to: BCG induction course · BCG maintenance course · Risk-adapted modified BCG pathwayOccupational or household exposure
Spillage or failure to follow live-agent handling and voiding precautions can expose others.
Applies to: BCG induction course · BCG maintenance course · Risk-adapted modified BCG pathwayOrthotopic neobladder reconstruction
Neobladder or ureteroenteric leak
Reservoir closure or a urinary anastomosis can leak, causing pelvic or abdominal collections and infection.
Applies to: Studer-type ileal neobladder · Spherical ileal neobladder · Male orthotopic neobladder · Female orthotopic neobladder · Intracorporeal neobladderBowel leak, ileus or obstruction
Bowel isolation and reconstruction can produce anastomotic failure, delayed recovery or later adhesive obstruction.
Applies to: Studer-type ileal neobladder · Spherical ileal neobladder · Male orthotopic neobladder · Female orthotopic neobladder · Intracorporeal neobladderUrinary infection or pyelonephritis
Mucus, residual urine, reflux and catheterisation can support recurrent lower- or upper-tract infection.
Applies to: Studer-type ileal neobladder · Spherical ileal neobladder · Male orthotopic neobladder · Female orthotopic neobladder · Intracorporeal neobladderDaytime or nocturnal incontinence
Reservoir pressure, sphincter function, sensation and adherence to timed emptying influence continence, especially at night.
Applies to: Studer-type ileal neobladder · Spherical ileal neobladder · Male orthotopic neobladder · Female orthotopic neobladder · Intracorporeal neobladderHypercontinence, retention or need for intermittent catheterisation
Outlet angulation, weak emptying mechanics or dysfunctional coordination can prevent complete emptying.
Applies to: Studer-type ileal neobladder · Spherical ileal neobladder · Male orthotopic neobladder · Female orthotopic neobladder · Intracorporeal neobladderUrethral or ureteroenteric stricture
Ischaemia and scar can narrow the reservoir outlet or upper-tract anastomoses.
Applies to: Studer-type ileal neobladder · Spherical ileal neobladder · Male orthotopic neobladder · Female orthotopic neobladder · Intracorporeal neobladderMetabolic, renal or nutritional consequences
Urine–bowel exchange, dehydration, impaired drainage and bowel resection can affect acid-base balance, renal function and nutrition.
Applies to: Studer-type ileal neobladder · Spherical ileal neobladder · Male orthotopic neobladder · Female orthotopic neobladder · Intracorporeal neobladderMucus retention or reservoir stone
Bowel mucus, foreign material, infection and incomplete emptying can block drainage or form stones.
Applies to: Studer-type ileal neobladder · Spherical ileal neobladder · Male orthotopic neobladder · Female orthotopic neobladder · Intracorporeal neobladderUrethral or upper-tract tumour recurrence
Preserved urothelium requires oncological selection and surveillance; diversion anatomy can complicate detection and access.
Applies to: Studer-type ileal neobladder · Spherical ileal neobladder · Male orthotopic neobladder · Female orthotopic neobladder · Intracorporeal neobladderPartial nephrectomy
Haemorrhage or conversion to radical nephrectomy
Hilar, segmental or tumour-bed bleeding can obscure the plane and threaten kidney preservation or patient stability.
Applies to: Robot-assisted partial nephrectomy · Laparoscopic partial nephrectomy · Open partial nephrectomy · Clamped partial nephrectomy · Off-clamp partial nephrectomy · Enucleation or enucleoresectionDelayed pseudoaneurysm or arteriovenous fistula
A partially controlled intrarenal vessel can present later with haematuria, pain or haemodynamic compromise.
Applies to: Robot-assisted partial nephrectomy · Laparoscopic partial nephrectomy · Open partial nephrectomy · Clamped partial nephrectomy · Off-clamp partial nephrectomy · Enucleation or enucleoresectionUrine leak or urinoma
Unrecognised or inadequately closed collecting-system entry can cause persistent drainage and collection.
Applies to: Robot-assisted partial nephrectomy · Laparoscopic partial nephrectomy · Open partial nephrectomy · Clamped partial nephrectomy · Off-clamp partial nephrectomy · Enucleation or enucleoresectionRenal ischaemic injury or loss of function
Vascular occlusion, parenchymal loss and reconstruction can reduce function in the operated kidney.
Applies to: Robot-assisted partial nephrectomy · Laparoscopic partial nephrectomy · Open partial nephrectomy · Clamped partial nephrectomyAdjacent-organ injury
Renal mobilisation and tumour location may place bowel, spleen, pancreas, liver, pleura or diaphragm at risk.
Applies to: Robot-assisted partial nephrectomy · Laparoscopic partial nephrectomy · Open partial nephrectomy · Clamped partial nephrectomy · Off-clamp partial nephrectomy · Enucleation or enucleoresectionUrinary, wound or intra-abdominal infection
Urine leak, haematoma and access wounds may become infected.
Applies to: Robot-assisted partial nephrectomy · Laparoscopic partial nephrectomy · Open partial nephrectomy · Clamped partial nephrectomy · Off-clamp partial nephrectomy · Enucleation or enucleoresectionPositive margin or tumour violation
Plane selection or lesion entry can compromise pathological interpretation and cancer-control confidence.
Applies to: Robot-assisted partial nephrectomy · Laparoscopic partial nephrectomy · Open partial nephrectomy · Clamped partial nephrectomy · Off-clamp partial nephrectomy · Enucleation or enucleoresectionIncisional hernia, port-site problem or chronic pain
Open, extraction and port wounds have different long-term abdominal-wall and pain profiles.
Applies to: Robot-assisted partial nephrectomy · Laparoscopic partial nephrectomy · Open partial nephrectomyRadical cystectomy and pelvic lymph-node dissection
Major haemorrhage or vascular injury
Pelvic sidewall, venous plexus and major-vessel injury can cause rapid blood loss and compromise oncological dissection.
Applies to: Open radical cystectomy · Robot-assisted radical cystectomy · Organ-sparing radical cystectomy · Salvage radical cystectomyRectal or bowel injury
Posterior dissection, adhesions and prior radiation can injure bowel and lead to contamination, leak or fistula.
Applies to: Open radical cystectomy · Robot-assisted radical cystectomy · Organ-sparing radical cystectomy · Salvage radical cystectomyObturator, autonomic or other nerve injury
Lymphadenectomy and deep pelvic dissection can affect leg function, sexual function and visceral autonomic control.
Applies to: Open radical cystectomy · Robot-assisted radical cystectomy · Organ-sparing radical cystectomy · Salvage radical cystectomyIleus or bowel obstruction
Major pelvic surgery and bowel handling can delay gastrointestinal recovery or produce early or late obstruction.
Applies to: Open radical cystectomy · Robot-assisted radical cystectomy · Organ-sparing radical cystectomy · Salvage radical cystectomyPelvic, urinary or wound infection
Urinary and bowel reconstruction, dead space and wounds create multiple infection routes.
Applies to: Open radical cystectomy · Robot-assisted radical cystectomy · Organ-sparing radical cystectomy · Salvage radical cystectomyVenous thromboembolism or cardiopulmonary event
Cancer, major pelvic surgery, immobility and physiological stress create substantial systemic risk.
Applies to: Open radical cystectomy · Robot-assisted radical cystectomy · Organ-sparing radical cystectomy · Salvage radical cystectomyLymphocele or lymphatic leak
Pelvic lymph-node dissection can leave symptomatic collections or persistent lymph drainage.
Applies to: Open radical cystectomy · Robot-assisted radical cystectomy · Organ-sparing radical cystectomy · Salvage radical cystectomyPositive margin or inadequate nodal staging
Plane selection, tumour extent or incomplete nodal/specimen handling can compromise staging or local control.
Applies to: Open radical cystectomy · Robot-assisted radical cystectomy · Organ-sparing radical cystectomy · Salvage radical cystectomySexual and reproductive dysfunction
Removal or denervation of pelvic organs can affect erections, ejaculation, vaginal function, fertility and body image; sparing reduces but does not remove risk.
Applies to: Open radical cystectomy · Robot-assisted radical cystectomy · Organ-sparing radical cystectomy · Salvage radical cystectomyRadical inguinal orchidectomy
Groin or scrotal haematoma
Cord, canal or scrotal bleeding can create painful swelling and obscure wound assessment.
Applies to: Standard radical inguinal orchidectomy · Radical orchidectomy with prosthesis · Radical orchidectomy after prior scrotal violation · Emergency radical orchidectomyWound or prosthesis infection
Groin wounds can become infected; an implant adds biofilm and explantation risk.
Applies to: Standard radical inguinal orchidectomy · Radical orchidectomy with prosthesis · Radical orchidectomy after prior scrotal violation · Emergency radical orchidectomyIlioinguinal or genitofemoral nerve injury and chronic pain
Nerve traction, division or scar can cause numbness, neuralgia or persistent groin discomfort.
Applies to: Standard radical inguinal orchidectomy · Radical orchidectomy with prosthesis · Radical orchidectomy after prior scrotal violation · Emergency radical orchidectomyScrotal violation or tumour spillage
Breach of tumour or scrotal planes can alter lymphatic dissemination risk and subsequent management.
Applies to: Standard radical inguinal orchidectomy · Radical orchidectomy with prosthesis · Radical orchidectomy after prior scrotal violation · Emergency radical orchidectomyInadequate cord length or specimen orientation
Low cord division or poor orientation can limit pathological assessment and local-control confidence.
Applies to: Standard radical inguinal orchidectomy · Radical orchidectomy with prosthesis · Radical orchidectomy after prior scrotal violation · Emergency radical orchidectomyProsthesis malposition, extrusion or dissatisfaction
An implant can sit too high or low, become painful, erode or fail to meet cosmetic expectations.
Applies to: Radical orchidectomy with prosthesisHypogonadism, fertility or body-image effects
Loss of a testis may affect endocrine reserve, fertility and psychological wellbeing, particularly with contralateral abnormality or further treatment.
Applies to: Standard radical inguinal orchidectomy · Radical orchidectomy with prosthesis · Radical orchidectomy after prior scrotal violation · Emergency radical orchidectomyRadical nephrectomy
Hilar or major-vessel injury
Renal artery, renal vein, IVC or aortic injury can cause catastrophic haemorrhage and require immediate change of operative strategy.
Applies to: Laparoscopic radical nephrectomy · Robot-assisted radical nephrectomy · Open radical nephrectomy · Radical nephrectomy with venous thrombectomy · Radical nephrectomy with adrenal or nodal resectionAdjacent-organ injury
Colon, duodenum, pancreas, spleen, liver, pleura or diaphragm can be injured during mobilisation or tumour dissection.
Applies to: Laparoscopic radical nephrectomy · Robot-assisted radical nephrectomy · Open radical nephrectomy · Radical nephrectomy with venous thrombectomy · Radical nephrectomy with adrenal or nodal resectionVenous tumour embolisation or incomplete thrombus removal
Thrombus manipulation without secure control can dislodge tumour or leave residual venous disease.
Applies to: Radical nephrectomy with venous thrombectomyAcute kidney injury or chronic renal decline
Removal of renal mass and perioperative physiological stress can impair overall renal function, especially with limited contralateral reserve.
Applies to: Laparoscopic radical nephrectomy · Robot-assisted radical nephrectomy · Open radical nephrectomy · Radical nephrectomy with venous thrombectomy · Radical nephrectomy with adrenal or nodal resectionWound, urinary or intra-abdominal infection
Haematoma, organ injury and access wounds can become infected after major renal surgery.
Applies to: Laparoscopic radical nephrectomy · Robot-assisted radical nephrectomy · Open radical nephrectomy · Radical nephrectomy with venous thrombectomy · Radical nephrectomy with adrenal or nodal resectionVenous thromboembolism, cardiac or pulmonary complication
Cancer, major surgery, positioning and vascular manipulation contribute to cardiopulmonary and thrombotic risk.
Applies to: Laparoscopic radical nephrectomy · Robot-assisted radical nephrectomy · Open radical nephrectomy · Radical nephrectomy with venous thrombectomy · Radical nephrectomy with adrenal or nodal resectionPositive margin, tumour rupture or incomplete staging
Tumour invasion, plane selection or specimen disruption can compromise local control and pathological assessment.
Applies to: Laparoscopic radical nephrectomy · Robot-assisted radical nephrectomy · Open radical nephrectomy · Radical nephrectomy with venous thrombectomy · Radical nephrectomy with adrenal or nodal resectionIncisional hernia, bulge or chronic pain
Port, extraction, flank and thoracoabdominal incisions have distinct risks of denervation, hernia and persistent pain.
Applies to: Laparoscopic radical nephrectomy · Robot-assisted radical nephrectomy · Open radical nephrectomyRadical nephroureterectomy with bladder cuff
Major haemorrhage or vascular injury
Renal hilar and pelvic vascular dissection can cause major blood loss.
Applies to: Open radical nephroureterectomy · Laparoscopic radical nephroureterectomy · Robot-assisted radical nephroureterectomy · Transvesical bladder-cuff excision · Extravesical bladder-cuff excision · RNU with template lymphadenectomyBladder leak or pelvic urinoma
Failure of bladder-cuff closure can cause pelvic urine extravasation and infection.
Applies to: Transvesical bladder-cuff excision · Extravesical bladder-cuff excisionContralateral ureteric-orifice or bowel injury
Pelvic cuff dissection and bladder closure can injure the opposite orifice or adjacent bowel.
Applies to: Open radical nephroureterectomy · Laparoscopic radical nephroureterectomy · Robot-assisted radical nephroureterectomy · Transvesical bladder-cuff excision · Extravesical bladder-cuff excisionTumour spillage or incomplete distal ureter removal
Collecting-system entry, ureteric transection or retained intramural ureter can compromise oncological quality.
Applies to: Open radical nephroureterectomy · Laparoscopic radical nephroureterectomy · Robot-assisted radical nephroureterectomy · Transvesical bladder-cuff excision · Extravesical bladder-cuff excisionBladder or systemic urothelial recurrence
Urothelial field disease and tumour biology create recurrence risk despite technically complete surgery.
Applies to: Open radical nephroureterectomy · Laparoscopic radical nephroureterectomy · Robot-assisted radical nephroureterectomy · Transvesical bladder-cuff excision · Extravesical bladder-cuff excision · RNU with template lymphadenectomyAcute kidney injury or chronic renal decline
Loss of a renal unit reduces reserve and may affect eligibility for subsequent systemic treatment.
Applies to: Open radical nephroureterectomy · Laparoscopic radical nephroureterectomy · Robot-assisted radical nephroureterectomy · Transvesical bladder-cuff excision · Extravesical bladder-cuff excision · RNU with template lymphadenectomyUrinary, wound or intra-abdominal infection
Bladder opening, urine leak, collections and incisions can become infected.
Applies to: Open radical nephroureterectomy · Laparoscopic radical nephroureterectomy · Robot-assisted radical nephroureterectomy · Transvesical bladder-cuff excision · Extravesical bladder-cuff excision · RNU with template lymphadenectomyLymphocele or nerve injury
Retroperitoneal or pelvic lymphadenectomy can create lymphatic collections or damage nearby autonomic and somatic nerves.
Applies to: RNU with template lymphadenectomyRadical prostatectomy and pelvic lymph-node dissection
Major bleeding or vascular injury
The dorsal venous complex, prostatic pedicles or pelvic vessels may bleed and obscure oncological planes.
Applies to: Robot-assisted radical prostatectomy · Open retropubic radical prostatectomy · Laparoscopic radical prostatectomy · Nerve-sparing radical prostatectomy · Radical prostatectomy with PLND · Salvage radical prostatectomyRectal or ureteric injury
Posterior dissection and bladder-neck reconstruction can injure adjacent bowel or ureter, with greater risk in salvage planes.
Applies to: Robot-assisted radical prostatectomy · Open retropubic radical prostatectomy · Laparoscopic radical prostatectomy · Nerve-sparing radical prostatectomy · Radical prostatectomy with PLND · Salvage radical prostatectomyVesicourethral anastomotic leak
Tension, tissue quality or a non-watertight anastomosis can cause pelvic urine leakage and delayed catheter removal.
Applies to: Robot-assisted radical prostatectomy · Open retropubic radical prostatectomy · Laparoscopic radical prostatectomy · Nerve-sparing radical prostatectomy · Radical prostatectomy with PLND · Salvage radical prostatectomyUrinary infection, pelvic collection or wound infection
Catheterisation, urine leak, lymphatic collections and incisions create several infection routes.
Applies to: Robot-assisted radical prostatectomy · Open retropubic radical prostatectomy · Laparoscopic radical prostatectomy · Nerve-sparing radical prostatectomy · Radical prostatectomy with PLND · Salvage radical prostatectomyLymphocele or lymphatic leak
Pelvic lymphadenectomy can create collections that compress vessels or urinary structures or become infected.
Applies to: Radical prostatectomy with PLNDVenous thromboembolism or cardiopulmonary event
Cancer, pelvic surgery, positioning and reduced mobility contribute to systemic perioperative risk.
Applies to: Robot-assisted radical prostatectomy · Open retropubic radical prostatectomy · Laparoscopic radical prostatectomy · Nerve-sparing radical prostatectomy · Radical prostatectomy with PLND · Salvage radical prostatectomyUrinary incontinence
Sphincter, urethral-length, bladder and supporting-tissue factors influence stress leakage and recovery.
Applies to: Robot-assisted radical prostatectomy · Open retropubic radical prostatectomy · Laparoscopic radical prostatectomy · Nerve-sparing radical prostatectomy · Radical prostatectomy with PLND · Salvage radical prostatectomyErectile dysfunction, anejaculation and orgasmic change
Seminal removal and neurovascular injury alter ejaculation, erections and orgasm; nerve sparing reduces but does not eliminate erectile risk.
Applies to: Robot-assisted radical prostatectomy · Open retropubic radical prostatectomy · Laparoscopic radical prostatectomy · Nerve-sparing radical prostatectomy · Radical prostatectomy with PLND · Salvage radical prostatectomyBladder-neck contracture or anastomotic stricture
Ischaemia, leak, bleeding and healing can narrow the reconstructed outlet.
Applies to: Robot-assisted radical prostatectomy · Open retropubic radical prostatectomy · Laparoscopic radical prostatectomy · Nerve-sparing radical prostatectomy · Radical prostatectomy with PLND · Salvage radical prostatectomyPositive surgical margin or inadequate nodal staging
Tumour extent, preservation choices or specimen and template quality can compromise cancer-control information.
Applies to: Robot-assisted radical prostatectomy · Open retropubic radical prostatectomy · Laparoscopic radical prostatectomy · Nerve-sparing radical prostatectomy · Radical prostatectomy with PLND · Salvage radical prostatectomySimple nephrectomy for a non-functioning benign kidney
Hilar or major-vessel injury
Inflammation can obscure, shorten or fix renal vessels and make vascular control unexpectedly hazardous.
Applies to: Laparoscopic simple nephrectomy · Robot-assisted simple nephrectomy · Open simple nephrectomy · Subcapsular nephrectomy · Nephrectomy for xanthogranulomatous or severely inflammatory diseaseBowel, pancreas, spleen, liver or diaphragmatic injury
Loss of normal tissue planes may make adjacent-organ injury or planned en-bloc management unavoidable.
Applies to: Laparoscopic simple nephrectomy · Robot-assisted simple nephrectomy · Open simple nephrectomy · Subcapsular nephrectomy · Nephrectomy for xanthogranulomatous or severely inflammatory diseaseSepsis or infected residual collection
An infected kidney, stone burden or abscess may disseminate infection or leave a postoperative infected space.
Applies to: Laparoscopic simple nephrectomy · Robot-assisted simple nephrectomy · Open simple nephrectomy · Subcapsular nephrectomy · Nephrectomy for xanthogranulomatous or severely inflammatory diseaseConversion to open or more extensive surgery
Unsafe visualisation, bleeding or organ adherence may require open exposure or a different dissection plane.
Applies to: Laparoscopic simple nephrectomy · Robot-assisted simple nephrectomy · Subcapsular nephrectomyAcute kidney injury or chronic renal decline
Although the removed unit contributes little, sepsis and surgery can impair contralateral renal function.
Applies to: Laparoscopic simple nephrectomy · Robot-assisted simple nephrectomy · Open simple nephrectomy · Subcapsular nephrectomy · Nephrectomy for xanthogranulomatous or severely inflammatory diseaseWound infection, hernia or chronic flank pain
Contamination and open or extraction incisions can impair healing and cause long-term abdominal-wall symptoms.
Applies to: Laparoscopic simple nephrectomy · Robot-assisted simple nephrectomy · Open simple nephrectomy · Subcapsular nephrectomy · Nephrectomy for xanthogranulomatous or severely inflammatory diseaseUnexpected malignancy or incomplete pathology orientation
Occult cancer can be discovered in a presumed benign specimen, making intact removal and clear documentation important.
Applies to: Laparoscopic simple nephrectomy · Robot-assisted simple nephrectomy · Open simple nephrectomy · Subcapsular nephrectomy · Nephrectomy for xanthogranulomatous or severely inflammatory diseaseTransurethral resection of bladder tumour
Obturator reflex with bladder injury
Lateral-wall energy can trigger sudden adductor contraction and drive the resection loop through the bladder.
Applies to: Conventional piecemeal TURBT · En-bloc TURBT · Enhanced-visualisation TURBT · Repeat resection TURBTExtraperitoneal or intraperitoneal perforation
Deep resection or mechanical injury can breach the bladder, with consequences determined by location, size and associated contamination or bleeding.
Applies to: Conventional piecemeal TURBT · En-bloc TURBT · Enhanced-visualisation TURBT · Repeat resection TURBTBleeding and clot retention
Tumour vessels and the resection bed may bleed immediately or after catheter removal and obstruct drainage.
Applies to: Conventional piecemeal TURBT · En-bloc TURBT · Enhanced-visualisation TURBT · Repeat resection TURBTUrinary infection or sepsis
Instrumentation, necrotic tumour, catheterisation and impaired drainage can contribute to infection.
Applies to: Conventional piecemeal TURBT · En-bloc TURBT · Enhanced-visualisation TURBT · Repeat resection TURBTUreteric-orifice injury or upper-tract obstruction
Resection or coagulation at an orifice can cause oedema, reflux or delayed stenosis.
Applies to: Conventional piecemeal TURBT · En-bloc TURBT · Enhanced-visualisation TURBT · Repeat resection TURBTInadequate staging specimen
Absent or uninterpretable detrusor, cautery artefact, fragmentation or poor labelling can prevent reliable staging.
Applies to: Conventional piecemeal TURBT · En-bloc TURBT · Enhanced-visualisation TURBT · Repeat resection TURBTResidual or missed tumour
Incomplete inspection or resection, occult flat disease and multifocal biology can leave clinically significant cancer.
Applies to: Conventional piecemeal TURBT · En-bloc TURBT · Enhanced-visualisation TURBT · Repeat resection TURBTUrethral stricture or bladder contracture
Repeated instrumentation and extensive mucosal treatment can cause delayed outlet narrowing or loss of bladder capacity.
Applies to: Conventional piecemeal TURBT · En-bloc TURBT · Enhanced-visualisation TURBT · Repeat resection TURBT