Robot-Assisted Cystoprostatectomy for Muscle-Invasive Bladder Cancer in a Patient With a Prior Simultaneous Pancreas-Kidney Transplantation.

INTRODUCTION

Kidney transplant recipients are at increased risk of malignancy due to chronic immunosuppression. Although rare (≈0.3%), bladder cancer in this population tends to be aggressive and may present with atypical symptoms. We report a case of muscle-invasive bladder cancer in a patient with prior simultaneous pancreas-kidney transplantation, successfully managed by fully intracorporeal robot-assisted radical cystoprostatectomy and urinary diversion.

PRESENTATION: A 46-year-old male with a history of a simultaneous pancreas and kidney transplantation presented with persistent storage lower urinary tract symptoms. Cystoscopy revealed a necrotic, atypical lesion with associated inflammatory changes. Preoperative CT urography showed thickening of the bladder dome, with peripheral enhancement and a calcified component. The patient underwent robot-assisted radical cystoprostatectomy with intracorporeal ileal conduit involving the transplanted kidney.

CLINICAL DISCUSSION: This rare case highlights the importance of thorough urological evaluation in transplant recipients presenting with atypical urinary symptoms.

CONCLUSION

This case demonstrates the feasibility and safety of fully intracorporeal robot-assisted cystoprostatectomy with urinary diversion in a patient with a simultaneous pancreas-kidney transplant.