Robot-Assisted Radical Prostatectomy in a Post-Kidney Transplant Patient: An Initial Case Report in China

Area of Science:

• Urology
• Oncology
• Transplant Surgery

Background:

• Robot-assisted radical prostatectomy (RARP) is a minimally invasive surgical technique for prostate cancer. Renal allograft recipients present unique surgical challenges due to anatomical variations and immunosuppression.
• Evaluating the safety and efficacy of RARP in this specific patient population is crucial for expanding treatment options.

Observation:

• A 62-year-old male with localized prostate cancer and a 12-year history of renal transplant underwent RARP.
• The procedure was performed using a transperitoneal posterior approach with careful preservation of the transplanted kidney and ureter.
• Lymph node dissection was limited to the right obturator region due to the allograft's position.

Findings:

• The RARP was completed in 230 minutes with minimal blood loss (200 mL) and no intraoperative or postoperative complications.
• Pathological results confirmed T2cN0M0, Gleason 3+3 prostate cancer.
• The patient achieved complete urinary continence post-catheter removal and maintained normal kidney function (serum creatinine and GFR) throughout the 21-month follow-up.
• No signs of cancer recurrence were observed.

Implications:

• RARP is a feasible and safe surgical option for prostate cancer in Chinese renal allograft recipients, offering good oncological and functional results.
• Routine prostate-specific antigen (PSA) screening is recommended for post-kidney transplant males to enable early prostate cancer detection.
• This study highlights the importance of tailored surgical approaches in complex patient populations.