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Advances in Urology
Volume 2009, Article ID 978038, 3 pages
Case Report

A Novel Use for the Rigid Cystoscope: The Removal of Sacral Tacks after a Coloanal Anastamosis Dehiscence

1Department of Urology, Ealing Hospital NHS Trust, Middlesex UB1 3HW, UK
2Department of Colo-Rectal Surgery, Ealing Hospital NHS Trust, Middlesex UB1 3HW, UK

Received 3 October 2008; Accepted 14 December 2008

Academic Editor: Douglas Scherr

Copyright © 2009 W. Mahmalji et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


A 69-year-old female presented as an emergency with atrial fibrillation, which was treated with warfarin. She subsequently developed fresh rectal bleeding and after further investigations a Dukes B adenocarcinoma of the rectum was found. She subsequently underwent a low anterior resection, coloanal anastamosis and a defunctioning ileostomy. Three sterile surgical metallic tacks (pins) were inserted into the sacrum to stop brisk bleeding from the presacral venous plexus. Following discharge, she was readmitted with septic shock and a CT scan revealed a presacral fluid collection in the area surrounding the sacral tacks (pins) and an anastamotic dehiscence. The patient was not fit for further pelvic surgery to remove the tacks, so an alternative minimally invasive cystoscopic procedure was performed. The sacral tacks (pins) were removed by the urologist using a rigid cystoscope and cold cup biopsy forceps. To our knowledge, this is the first reported case in the literature.