Robot-Assisted Cystoprostatectomy for Muscle-Invasive Bladder Cancer in a Patient With a Prior Simultaneous...

Area of Science:

• Urology
• Oncology
• Transplant Surgery

Background:

• Kidney transplant recipients (KTRs) have an elevated cancer risk due to immunosuppression.
• Bladder cancer is rare (≈0.3%) in KTRs but often aggressive and presents atypically.
• Simultaneous pancreas-kidney transplantation (SPKT) adds complexity to managing KTRs.

Purpose of the Study:

• To report a case of muscle-invasive bladder cancer in an SPKT recipient.
• To highlight the diagnostic challenges of atypical bladder cancer symptoms in KTRs.
• To demonstrate the feasibility and safety of minimally invasive surgical management.

Main Methods:

• A 46-year-old SPKT recipient presented with lower urinary tract symptoms.
• Diagnostic workup included cystoscopy and CT urography.
• The patient underwent a fully intracorporeal robot-assisted radical cystoprostatectomy with ileal conduit urinary diversion.

Main Results:

• The patient was diagnosed with muscle-invasive bladder cancer.
• Robot-assisted radical cystoprostatectomy with intracorporeal urinary diversion was successfully performed.
• The procedure involved the transplanted kidney, demonstrating technical feasibility.

Conclusions:

• Thorough urological evaluation is crucial for transplant recipients with atypical urinary symptoms.
• Fully intracorporeal robot-assisted radical cystoprostatectomy is a safe and feasible option for bladder cancer in SPKT patients.
• This approach offers a minimally invasive solution for complex urological oncology cases in transplant recipients.