Gleason Score 4þ4[8 prostate cancer. The patient proceed with a robotic-assisted laparoscopic prostatectomy with a urethral pull through and bilateral pelvic lymph node dissection. The video begins with dissection of the prostatic apex to entirely free up and remove the prostate. Once the prostate is separated from the urethra, the dissection continues until the old bulbar urethral scar is completely removed. After we ensure the remnant urethra is free of scar and patent, the urethra is seen being passed through from below into the pelvic cavity and the anastomosis is performed. We then proceeded with a bilateral pelvic lymphadenectomy using the synchroseal device which obviates the need for any clips. The patient's inflatable prosthesis reservoir makes the right side more challenging, however, it is feasible with careful dissection.RESULTS: The patient was discharged on post-operative day 1 with all drains removed and his post-operative course remained uncomplicated. On post-operative day 19, he had a normal voiding cystourethrogram.CONCLUSIONS: This case discusses the surgical technique used in a salvage robotic-assisted prostatectomy with membranous urethral pull-through in a patient with previous history of HIFU, salvage EBRT, bulbar urethral stricture, and inflatable penile prosthesis. In this video, we show this is a feasible option in select men and may spare them the burden from undergoing a radical cystoprostatectomy.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.