The Surgical Management of Prostate Cancer in Renal Transplant Recipients: The Minimally Invasive Approach.
Mahmoud Farzat, Ibrahim Al-Taie, Florian M Wagenlehner
✦ AI-curated · Sources linked
Case in brief
A 66-year-old man with localized Gleason 3 + 4 = 7a prostate cancer and a functioning renal transplant in the right iliac fossa underwent nerve-sparing robot-assisted radical prostatectomy with bilateral pelvic lymphadenectomy. Histopathology showed organ-confined acinar adenocarcinoma (pT2c), negative margins, and no nodal metastases. After clamping the suprapubic catheter to allow natural urination, renal parameters temporarily increased; they resolved after the catheter was reopened for a few days. Ultrasound showed preserved graft perfusion without hydronephrosis or lymphocele.
What made this case unusual
Pelvic surgery posed a graft-specific risk because the transplanted kidney, its iliac vascular anastomoses, and its short ureter implanted into the bladder were near the operative field, including during lymphadenectomy.
Diagnostic / clinical pearl
After prostatectomy in a renal transplant recipient, a temporary rise in renal parameters during catheter clamping may resolve when suprapubic drainage is restored; assess graft perfusion and urinary tract findings.
Why it matters
The case supports the feasibility of robot-assisted radical prostatectomy with bilateral pelvic lymphadenectomy in a renal transplant recipient when meticulous technique is used to protect graft function.