Robotic Salvage Retropubic Prostatectomy After Radiation/Brachytherapy: Initial Results

Main Category: Prostate / Prostate Cancer
Also Included In: Urology / Nephrology
Article Date: 19 Jun 2008 - 12:00 PDT

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UroToday.com - Dr. Kaouk and colleagues at the Cleveland Clinic report their initial case series of robotic salvage retropubic prostatectomy (SRP) in the online version of the BJU International. The authors initially performed robotic cystoprostatectomy on 2 patients with irradiated prostates and bladder cancer. They then performed SRP on 4 consecutive patients after local treatment failure. Prostate biopsies confirmed local recurrence and metastatic workups did not demonstrate distant disease.

All of these 4 men had initially been treated with brachytherapy and 2 had additional boost radiotherapy. The mean preoperative PSA was 3.85ng/ml. Mean operative duration was 125 minutes and mean blood loss was 117 cc. Mean hospital stay was 48 hours. All patients had pelvic lymphadenectomy and were found to have negative lymph nodes. Two of three patients with extraprostatic extension had positive surgical margins. No patient had a rectal injury or required a blood transfusion. Foley catheter drainage time was 15 days. Urinary control was good with only one pad per day usage in 3 patients at one month. Three of the men had an undetectable PSA at mean follow-up of 5 months.

These data suggest that in experienced hands, SRP is a treatment option and thus deserves further study.

Kaouk JH, Hafron J, Goel R, Haber GP, Jones JS
BJU Int. 2008 Apr 10 (Epub ahead of print)
10.1111/j.1464-410X.2008.07570.x

Reported by UroToday.com Contributing Editor Christopher P. Evans, MD, FACS

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