Hem-o-lok clips are widely used in robotic-assisted radical prostatectomy (RARP). However, clips-related complications have been reported, including intravesical migration. Here, we share a 60-year-old male case with newly diagnosed prostatic adenocarcinoma. With an unfavorable intermediate risk, he was admitted for RARP. He was discharged from hospital without any immediate complications. However, he reported progressive dysuria and slow urine stream 6 months after surgery. Cystoscopy showed severe bladder neck contracture (BNC), and 2 Hem-o-lok clips were found intravesically and removed during bladder neck incision. Subsequently, fiberocystoscopy revealed another 2 clips near the bladder neck with mild BNC after another 6 months. These 2 clips were also removed during bladder neck dilatation. His urination status then improved without further obstruction. Clip migration after RARP is uncommon; however, clinicians must keep this in mind when patients present with new complaints such as lower urinary tract symptoms, hematuria, and recurrent urinary tract infections.

1.
Yu
CC
,
Yang
CK
,
Ou
YC
.
Three types of intravesical Hem-o-lok clip migration after laparoscopic radical prostatectomy
.
J Laparoendosc Adv Surg Tech A
.
2015 Dec
;
25
(
12
):
1005
8
. .
2.
Turini
GA
 3rd
,
Brito
JM
 3rd
,
Leone
AR
,
Golijanin
D
,
Miller
EB
,
Pareek
G
,
Intravesical hemostatic clip migration after robotic prostatectomy: case series and review of the literature
.
J Laparoendosc Adv Surg Tech A
.
2016 Sep
;
26
(
9
):
710
2
.
3.
Shin
YS
,
Doo
AR
,
Cha
JS
,
Kim
MK
,
Jeong
YB
,
Kim
HJ
.
Floating Hem-o-lok clips in the bladder without stone formation after robot-assisted laparoscopic radical prostatectomy
.
Korean J Urol
.
2012 Jan
;
53
(
1
):
60
2
. .
4.
Cormio
L
,
Massenio
P
,
Lucarelli
G
,
Di Fino
G
,
Selvaggio
O
,
Micali
S
,
Hem-o-lok clip: a neglected cause of severe bladder neck contracture and consequent urinary incontinence after robot-assisted laparoscopic radical prostatectomy
.
BMC Urol
.
2014 Feb 20
;
14
:
21
.
5.
Chen
YC
,
Chen
HW
,
Lee
CH
,
Huang
SP
.
A rare delayed bladder migration of a Hem-o-lok clip 5 years after robotic-assisted radical prostatectomy
.
Urol Int
.
2019
;
102
(
4
):
495
8
. .
6.
Blumenthal
KB
,
Sutherland
DE
,
Wagner
KR
,
Frazier
HA
,
Engel
JD
.
Bladder neck contractures related to the use of Hem-o-lok clips in robot-assisted laparoscopic radical prostatectomy
.
Urology
.
2008 Jul
;
72
(
1
):
158
61
. .
7.
Yi
JS
,
Kwak
C
,
Kim
HH
,
Ku
JH
.
Surgical clip-related complications after radical prostatectomy
.
Korean J Urol
.
2010 Oct
;
51
(
10
):
683
7
. .
8.
Edward Schaeffer
M
.
National Comprehensive Cancer Network Clinical Practice Guidelines in oncology: prostate cancer
.
2021
.
9.
Novara
G
,
Ficarra
V
,
Rosen
RC
,
Artibani
W
,
Costello
A
,
Eastham
JA
,
Systematic review and meta-analysis of perioperative outcomes and complications after robot-assisted radical prostatectomy
.
Eur Urol
.
2012 Sep
;
62
(
3
):
431
52
.
10.
Hu
JC
,
Nelson
RA
,
Wilson
TG
,
Kawachi
MH
,
Ramin
SA
,
Lau
C
,
Perioperative complications of laparoscopic and robotic assisted laparoscopic radical prostatectomy
.
J Urol
.
2006 Feb
;
175
(
2
):
541
6
; discussion 46.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.