Therapeutic Advances in Urology (Jun 2021)

Robotic radical cystectomy with concomitant implantation of 3-piece penile prosthesis: a one-step solution

  • Alessandro Izzo,
  • Giuseppe Quarto,
  • Giovanni Grimaldi,
  • Luigi Castaldo,
  • Raffaele Muscariello,
  • Dario Franzese,
  • Paola Del Prete,
  • Matteo Ferro,
  • Daniela Barberio,
  • Ida Bolognini,
  • Attilio Antonio Montano Bianchi,
  • Riccardo Autorino,
  • Sisto Perdonà

DOI
https://doi.org/10.1177/17562872211024512
Journal volume & issue
Vol. 13

Abstract

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Radical cystectomy (RC) remains a highly morbid urologic procedure, and erectile dysfunction (ED) represents a significant burden for bladder cancer survivors. While inflatable penile prosthesis (IPP) offers a definitive treatment option for post-RC ED, the hostile postoperative anatomy of RC patients poses some technical challenges for IPP implantation. We report the case of a 54-year-old male with high grade bladder cancer who was managed with a robotic-assisted RC with Bricker ileal conduit urinary diversion and simultaneous implantation of a 3-piece IPP. Operative time was 310 min (230 min for the RC and ileal conduit portion, 80 min for IPP implantation). Estimated blood loss was 300 ml. Postoperative course was regular. The patient was discharged home on postoperative day 6. A robotic RC with concomitant IPP implantation can be offered as “one-step” solution to bladder cancer male patients. This approach can potentially offer the advantage of better outcome in terms of sexual function, while minimizing surgical risks, ultimately improving the quality of life of these patients.