Robot-assisted laparoscopic radical prostatectomy after previous open transvesical adenomectomy.

Bove, Alfredo Maria; Altobelli, Emanuela; Sergi, Federico; Buscarini, Maurizio

INTRODUCTION Robot-assisted laparoscopic radical prostatectomy (RALRP) is one of the best treatment for patients with localized prostate cancer. RALRP is currently performed in patients without previous surgical treatment for benign prostatic hyperplasia. This paper presents a successfully performed RALRP after previous open transvesical adenomectomy (TVA). CASE REPORT A 68-year-old patient underwent nerve-sparing RALRP for prostate cancer revealed by transrectal ultrasound guided prostate biopsy, 7 years after TVA. RESULTS Postoperatively, a regular diet was allowed on day 1. The Foley catheter was removed on day 7. At 3 months' follow-up, the patient complained of moderate stress incontinence but erectile function was responsive to Tadalafil(®). Serum prostate-specific antigen was undetectable. Quality of life was satisfactory. CONCLUSIONS A history of previous prostatic surgery does not appear to compromise the outcome of RALRP. Nerve sparing is still indicated. Long-term follow-up is necessary to define RALRP as a gold standard also in patients with previous TVA.