Radical prostatectomy (RP) in patients on continuous ambulatory peritoneal dialysis (CAPD) is a challenging procedure. The following key points need to be considered: the peritoneal cavity integrity, adjustment of the trocar positions to the peritoneal dialysis (PD) tube location, and the oncological and functional outcomes. We present a clinical case of a patient on CAPD, incidentally diagnosed with prostate cancer (PCa) during the pre-transplant evaluation. The patient suffered from LUTS, due to bladder outlet obstruction (BOO). A transurethral bladder neck incision (TUNI), with median lobe resection, was performed. A PCa Gleason score of six (3 + 3) was found in the histopathological specimen. The primary procedure was complicated by bladder neck sclerosis and acute urinary retention (AUR), resolved by suprapubic cystostomy. After proper staging determination, the patient was qualified for laparoscopic extraperitoneal RP. The standard trocar placement was modified to align with the route of the PD tube, and Retzius' space scarring was released to allow extraperitoneal prostatectomy. There were no signs of peritoneal wall damage or dialysis tube displacement. Peritoneal dialysis was resumed after 4 weeks. Laparoscopic extraperitoneal RP should be considered as an acceptable treatment method for selected patients with localized prostate cancer, allowing CAPD resumption. To the best of our knowledge, this is the first report of retroperitoneal laparoscopic RP being used in the PD population.
Life (Basel, Switzerland). 2022 Mar 12*** epublish ***
Damian Widz, Iga Kuliniec, Andriy Yadlos, Damian Sudoł, Michał Godzisz, Agata Wisz, Paweł Płaza, Przemysław Mitura, Michał Cabanek, Krzysztof Bar
Department of Urology and Oncological Urology, Medical University of Lublin, Jaczewskiego 8, 20-954 Lublin, Poland., Department of Diagnostic Imaging, Radiology and Nuclear Medicine, Faculty of Medical Science in Katowice, Medical University of Silesia, Medyków 16, 40-752 Katowice, Poland.