Robot-assisted radical cystectomy using real-time transrectal ultrasound guidance in a patient who had radical prostatectomy and salvage external beam radiation therapy

Introduction

Radical cystectomy for patients who previously underwent both radical prostatectomy and prostatic bed radiation is technically challenging.

Case presentation

A 78-year-old man with a history of radical prostatectomy and salvage radiation for prostate cancer was referred to our hospital for radical treatment of bladder cancer. After two cycles of neoadjuvant chemotherapy, he underwent robot-assisted radical cystectomy with real-time transrectal ultrasound guidance during dissection of the rectovesical space to minimize the risk of rectal injury. There were no perioperative adverse events.

Conclusion

Intraoperative real-time transrectal ultrasound guidance could assist surgeons to safely perform the dissection of the rectovesical space in the surgically high-risk patient.