Robot Surgery for Midline Cysts of the Prostate With Hypospadias in the Pediatric Population.

OBJECTIVE

To summarize the experience of using robotic surgery to treat midline cysts (MLC) of the prostate in pediatric patients with hypospadias, and to introduce and evaluate the initial outcome of seminal passage reconstruction via robot-assisted laparoscopy during the removal of symptomatic MLCs.

PATIENTS AND

METHODS

We included a case series of 17 symptomatic MLCs with hypospadias. All patients received both genetic and fertility evaluation. MLCs were removed via robot-assisted laparoscopy and the seminal passage was reconstructed in 7 patients.

RESULTS

Five patients were assessed as fertile as adults, while the other 12 were assessed as infertile. All 17 patients received robot-assisted laparoscopic surgery to remove MLCs, and 7 patients received reconstruction of the seminal passage. Patients were followed-up for 5-24 months; there were no serious adverse events except for 1 patient who experienced a single occurrence of epididymitis 7 months after reconstruction of the seminal passage. There were no significant cystic remnants in any of the patients upon ultrasonography and/or urethrography after surgery. Urethroscopy and vasography were performed in 2 patients after reconstruction; in both cases, unobstructed seminal passages were indicated.

CONCLUSION

Reconstruction of the seminal passage is practical when carried out by robot-assisted techniques. Initial results indicated that the reconstruction operations were able to restore patency in the seminal duct in some of the patients. Fertility is the goal of this technique, and long-term follow-up is needed.