Robot-assisted laparoscopic radical prostatectomy after previous open trans-vescical adenomectomy: a case report

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 (BPH). 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 trans rectal ultrasound guided prostate biopsy, 7 years after TVA. Results: Postoperatively, a regular diet was allowed on day 1. Foley catheter was removed on day 7. At 3 months follow-up, patient complained moderate stress incontinence but erectile function was responsive to Tadalafil®. Serum PSA was undetectable. Quality of life was satisfactory. Conclusions: In our experience, 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 patient with previous TVA.