Rhabdomyolysis Following Robot-Assisted Radical Prostatectomy.
Ibrahim Al-Taie, Florian M Wagenlehner, Mahmoud Farzat
✦ AI-curated · Sources linked
Case in brief
A 66-year-old man with obesity, insulin-dependent diabetes, and multiple comorbidities underwent robot-assisted radical prostatectomy for cT3a cN1 prostate cancer, with approximately 4 hours of console time. Immediately afterward, he developed severe gluteal pain, sensorimotor deficits, and massive rhabdomyolysis, followed by anuric acute kidney injury and respiratory insufficiency. His course was complicated by heparin-induced thrombocytopenia type II and a grade IV gluteal pressure ulcer. After intensive care, including continuous hemodiafiltration and transfusion of 12 units of erythrocytes, renal function partially recovered; he was discharged with minimal residual neuropathic deficits.
What made this case unusual
Severe rhabdomyolysis with gluteal pressure injury and neurologic deficits followed prolonged positioning for robotic prostatectomy, with life-threatening renal and respiratory complications.
Diagnostic / clinical pearl
After prolonged positioning for robot-assisted prostatectomy, new severe gluteal pain or sensorimotor deficits should prompt consideration of positioning-related muscle injury and rhabdomyolysis.
Why it matters
The case underscores the value of preoperative risk assessment and coordinated multidisciplinary management when serious complications arise after prolonged operative positioning.