Feasibility of Laparoscopic Partial Cystectomy for Bladder Paraganglioma: A Four-Case Series.

Urinary bladder paraganglioma is a rare tumor associated with a risk of catecholamine-induced hypertensive crisis during tumor manipulation. The optimal surgical approach remains uncertain, particularly for larger tumors or those with suspected local invasion. We report four cases managed at our institution. All tumors were diagnosed preoperatively by magnetic resonance imaging and 123I-metaiodobenzylguanidine scintigraphy, and all patients received preoperative α-blockade. Three tumors (1.0-1.5 cm) without extravesical extension were treated with laparoscopic partial cystectomy without conversion. One larger tumor (4.3 cm) with suspected local invasion was managed using a planned open procedure and was associated with marked intraoperative hypertension and technical difficulty. These findings suggest that laparoscopic partial cystectomy is technically feasible in selected patients with small, localized bladder paragangliomas, whereas tumor size and suspected local invasion may influence surgical planning. The technical requirements for complete resection and catecholamine-related hemodynamic risk should be assessed separately.