Robot-Assisted Laparoscopic Prostatectomy in Patients with Preexisting Three-Piece Inflatable Penile Prosthesis

Abstract

INTRODUCTION: Robotic-assisted laparoscopic radical prostatectomy (RARP) is becoming the preferred surgical treatment option for management of organ-confined prostate cancer. Although not a contraindication, previous pelvic surgery can make RARP challenging. Presence of a three-piece inflatable penile prosthesis, with a perivesical pelvic reservoir, has the potential to induce steric hindrance making RARP difficult. AIM: The main purpose of this publication is to report our experience with RARP in patients with previously inserted three-piece inflatable penile prostheses. METHODS: Two patients with previously inserted AMS 700 penile prosthesis and with organ-confined, biopsy proven adenocarcinoma of the prostate underwent RARP. We describe intraoperative findings, surgical technique, oncologic and functional outcomes. RESULTS: Both patients underwent safe and successful RARP with out any complications. Surgical margins were not affected with pelvic reservoir-sparing technique. In both patients, the penile prosthesis remained functional postoperatively. CONCLUSIONS: RARP can be safely performed in patients with previously inserted three-piece inflatable penile prosthesis. Nontraumatic handling of the pelvic reservoir is mandatory to preserve prosthesis' integrity.