A Case Series of Patients Who Underwent Laparoscopic Extraperitoneal Radical Prostatectomy with the Simultaneous Implant of a Penile Prosthesis: Focus on Penile Length Preservation

Abstract Background The incidence of prostate cancer in renal transplant recipients (RTR) is similar to the general population. Radical prostatectomy (RP) is the standard of care in the management of clinically localized cancer, but is considered complicated due to the presence of adhesions, and the location of transplanted ureter/kidney. To date, a few case series or studies on RP in RTR have been published, especially in Asian patients. This study aimed to evaluate the efficacy and safety and report the experience with RP on RTR. Methods We retrospectively reviewed data of 1270 patients who underwent RP from January 2008 to March 2020, of which 5 patients were RTR. All available baseline characteristics, perioperative and postoperative data (operative time, estimated blood loss (EBL), complications, length of hospital stay, complication), pathological stage, Gleason score, surgical margin status, and pre/postoperative creatinine were reviewed. Results Of the 5 RTR who underwent RPs (1 open radical prostatectomy (ORP), 1 laparoscopic radical prostatectomy (LRP), 2 robotic-assisted laparoscopic radical prostatectomies (RALRP), and 1 Retzius-sparing RALRP (RS-RALRP)) prostatectomy, the mean age (± SD) was 70 (± 5.62) years. In LRP and RALRP cases, the standard ports were moved slightly medially to prevent graft injury. The mean operative time ranged from 190 to 365 min. The longest operative time and highest EBL (630 ml) was the ORP case due to severe adhesion in Retzius space. For LRP and RALRP cases, the operative times seemed comparable and had EBL of ≤ 300 ml. All RPs were successful without any major intra-operative complication. There was no significant change in graft function. The restorations of urinary continence were within 1 month in RS-RALRP, approximately 6 months in RALRP, and about 1 year in ORP and LRP. Three patients with positive surgical margins had prostate-specific antigen (PSA) persistence at the first follow-up and 1 had later PSA recurrence. Two patients with negative margins were free from biochemical recurrence at 47 and 3 months after their RP. Conclusions Our series suggested that all RP techniques are safe and feasible mode of treatment for localized prostate cancer in RTR.

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MP48-10 TADALAFIL ONCE A DAY SIGNIFICANTLY REDUCES PENILE LENGTH-LOSS IN PATIENTS POST BILATERAL NERVE-SPARING RADICAL PROSTATECTOMY (NSRP) - RESULTS FROM A RANDOMIZED CONTROLLED TRIAL

The Journal of Urology ◽

10.1016/j.juro.2014.02.1484 ◽

2014 ◽

Vol 191 (4S) ◽

Cited By ~ 1

Author(s):

Gerald Brock ◽

Francesco Montorsi ◽

Pierre Costa ◽

Nimish Shah ◽

Jose Maria Martinez Jabaloyas ◽

...

Keyword(s):

Randomized Controlled Trial ◽

Radical Prostatectomy ◽

Controlled Trial ◽

Nerve Sparing ◽

Penile Length ◽

Randomized Controlled

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Penile Prosthesis Placement with Immediate Buried Penis Correction: A Retrospective Chart Review

Surgical Case Reports ◽

10.31487/j.scr.2021.02.11 ◽

2021 ◽

pp. 1-3

Author(s):

Christopher J. Salgado ◽

Genesis Navas ◽

Lalama Maria ◽

Lindsay M. Tanner ◽

...

Keyword(s):

Erectile Dysfunction ◽

Chart Review ◽

Functional Performance ◽

Case Series ◽

Penile Prosthesis ◽

Retrospective Chart Review ◽

Combined Approach ◽

Suspensory Ligament ◽

Cosmetic Appearance ◽

Buried Penis

Introduction: We present a case report on six patients who underwent a combined approach to improve the cosmetic appearance and functional performance of their buried penis. Aim: To report our combined approach to improve both buried penis and erectile dysfunction. Methods: In one surgery, we performed: a malleable penile prosthesis, ventral phalloplasty, and penile suspensory ligament release followed by a suprapubic lipectomy. Results: Postoperatively, all patients had an increase in penile length and were able to achieve successful penetrative intercourse. The average difference between the pre-operational and post-operational flaccid length of our six patients was 3.5 cm ± 1.38 (range, 1.9 to 5.08 cm). Conclusion: This case series serves as successful examples of using a combined approach in one stage to not only improve the cosmetic appearance of a buried penis but also address erectile dysfunction.

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P154 DOES A PENO-SCROTAL APPROACH FOR PENILE PROSTHESIS IMPLANTATION INCREASE THE INCIDENCE OF INGUINAL HERNIAS POSTOPERATIVELY?

British Journal of Surgery ◽

10.1093/bjs/znab395.144 ◽

2021 ◽

Vol 108 (Supplement_8) ◽

Author(s):

Shadi Al-Bahri ◽

Hazem Taifour

Keyword(s):

Risk Factors ◽

Inguinal Hernia ◽

Case Series ◽

Penile Prosthesis ◽

Signs And Symptoms ◽

General Surgeon ◽

Direct Inguinal Hernia ◽

Prosthesis Implantation ◽

Radiologic Imaging ◽

History Of

Abstract Aim The incidence of direct inguinal hernia and reservoir migration post-penile prosthesis implantation is extremely rare. We present a case series of patients presenting with direct inguinal hernia following three-piece penile prosthesis implantation. Material and Methods Three patients presented with direct inguinal hernia shortly following penile prosthesis implantation for treatment of refractory erectile dysfunction due to venous leak that was confirmed on ultrasound imaging. All patients underwent standard open Lichtenstein tension free repair. Results All patients underwent penile prosthesis Implantation through a peno-scrotal approach in which the reservoir was placed in the space of Retzius. The first patient had reservoir displacement one day post-operatively presenting as an inguinal bulge and discomfort, and repaired the same day. The other two patients presented with symptoms of inguinal swelling and pain at 40 days and 8 months respectively. None of our patients had signs and symptoms of intestinal obstruction. Identifiable risk factors included high BMI and a history of smoking, however dissection and placement of the reservoir may play a role in weakening the floor of the inguinal canal. Conclusions Despite the rare incidence of inguinal hernia post-penile prosthesis implantation, identification of patients with risk factors for inguinal hernia development should be done preoperatively. This may be evaluated through preoperative radiologic imaging with an abdominal wall ultrasound or clinical examination by a general surgeon.

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