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CASE REPORT
Femoral neuropathy following a psoas hitch vesicopexy
  1. Caspar Müller1,
  2. Elvira Esmeralda van Houwelingen1,
  3. Frank Huygen2
  1. 1Erasmus MC, Rotterdam, The Netherlands
  2. 2Department of Anaesthesiology, erasmusMC, Rotterdam, The Netherlands
  1. Correspondence to Mr Caspar Müller, c.muller{at}erasmusmc.nl

Summary

A 68-year-old man classified as III on the American Society of Anaesthesiologists (ASA) physical status classification system, with a high-grade papillary urothelial cell carcinoma of the left distal ureter, underwent open retroperitoneal distal ureterectomy followed by a ureteroneocystostomy with a vesico-psoas hitch. Postoperatively, the patient complained of left proximal lower limb weakness, severe pain and hypaesthesia of the ventral left thigh suggestive of femoral neuropathy. After excluding common causes for postsurgical pain, a surgical re-exploration was eventually performed during which the sutures used in the vesicopexy were removed, resulting in almost complete resolution of the symptoms. Electromyographic analysis 4 weeks after discharge confirmed the diagnosis of femoral neuropathy, most likely caused by the sutures used in the vesicopexy. This is a rare complication with major consequences for postoperative recovery.

  • urology
  • anaesthesia
  • pain
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Footnotes

  • Contributors CM and EEvH: contributed equally to this manuscript in writing, came up with ideas and finalised the manuscript. FH: reviewed the article and provided expert advice on the article.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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