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Polymyalgia rheumatica following robotic radical prostatectomy.
T Suntharasivam1, V J Gnanapragasam
1Department of Urology, Addenbrookes Hospital, Hills Road, Cambridge CB2 0QQ, United Kingdom.
International Journal of Surgery Case Reports
|May 18, 2012
Summary
Polymyalgia rheumatica (PMR) can occur after surgery. This case report details a patient who developed PMR after robotic prostate surgery, suggesting a potential link between surgical procedures and this inflammatory condition.
Area of Science:
- Rheumatology
- Urology
- Oncology
Background:
- Polymyalgia rheumatica (PMR) is an inflammatory syndrome with unknown causes, sometimes linked to cancer.
- This study focuses on a de novo case of PMR in a patient post-robotic radical prostatectomy.
Purpose of the Study:
- To report the first case of polymyalgia rheumatica (PMR) developing after robotic prostate surgery.
- To explore the potential link between robotic prostatectomy and the onset of PMR.
Main Methods:
- A 67-year-old male underwent robotic assisted radical prostatectomy for a T2(C) Gleason 7 tumor.
- Post-surgery, the patient developed symptoms consistent with PMR, including elevated ESR and CRP.
- Symptoms resolved rapidly with oral steroid treatment.
Main Results:
- The patient presented with symptoms of PMR three weeks after robotic prostatectomy.
- Laboratory tests showed significantly elevated ESR and CRP, supporting the PMR diagnosis.
- The patient experienced rapid symptom relief following corticosteroid therapy.
Conclusions:
- This is the first reported instance of polymyalgia rheumatica (PMR) occurring acutely after radical robotic prostatectomy.
- Surgical procedures, including robotic prostatectomy, may trigger PMR through immune-mediated inflammatory responses.
- Potential mechanisms include inflammatory marker release from tissue injury and surgical stress-induced immune system activation.