Robotic Salvage Seminal Vesiculectomy for radio-recurrent prostate cancer post LDR brachytherapy following multiple negative trans-perineal biopsies

Dr Athos Katelaris; Dr Damien Gibson; Dr Sunny Nalavenkata; Dr James Thompson

doi:10.1016/j.eucr.2022.102064

Robotic Salvage Seminal Vesiculectomy for radio-recurrent prostate cancer post LDR brachytherapy following multiple negative trans-perineal biopsies

Urol Case Rep. 2022 Mar 25:43:102064. doi: 10.1016/j.eucr.2022.102064. eCollection 2022 Jul.

Authors

Dr Athos Katelaris^{1

2}, Dr Damien Gibson¹, Dr Sunny Nalavenkata^{1

2}, Dr James Thompson^{1

2}

Affiliations

¹ Department of Urology, St George Hospital, Sydney, Australia.
² The University of New South Wales, Sydney, Australia.

Abstract

Multi-parametric Magnetic Resonance Imaging (mp-MRI) and prostate membrane specific antigen positron emission tomography (PSMA-PET) CT scan in prostate cancer has led to enhanced detection of local and metastatic recurrence post-radiotherapy. A 59-year-old man presented with biochemical relapse following low dose rate brachytherapy for ISUP 2 T1cN0M0 prostate cancer (PCa). Despite strong biochemical and radiological evidence of radio-recurrent PCa in his right seminal vesicle, serial transperineal biopsies revealed benign tissue. He proceeded to Robot Assisted Salvage Seminal Vesiculectomy (RSSV) as a diagnostic procedure without complication. Histo-pathology confirmed a 23 × 17 × 13mm focus of Gleason 4 + 4 adenocarcinoma in the SV with clear surgical margins.

Keywords: Biochemical recurrence; Brachytherapy; Local recurrence; Prostate cancer; Robotic salvage seminal vesiculectomy.

Publication types

Case Reports