title: Radical retropubic prostatectomy for localized prostate cancer in renal transplant patients.
abstract: OBJECTIVE
  To investigate the feasibility of radical retropubic prostatectomy (RRP) in renal transplant recipients with clinically localized prostate cancer.
  
  
  METHODS
  A prospective protocol was established between August 2004 and November 2007. In that period, 8 patients diagnosed with localized prostate cancer were submitted to RRP, and their clinicopathologic data were reviewed.
  
  
  RESULTS
  The mean age (+/- standard deviation) at surgery was 59.6 +/- 6.7 years (range, 49-67 years). All patients had T1C tumors, except for 1 with a T2A tumor. The mean preoperative prostate-specific antigen value was 4.5 +/- 1.8 ng/mL (range, 1.6-7.0 ng/mL). The mean interval between renal transplantation and RRP was 89.9 +/- 65.1 months (range, 40-209 months). The procedure was well tolerated without major complications, and all patients were discharged on the fifth postoperative day. There was no impairment to bladder descent caused by the presence of the allograft or the ureteroneocystostomy. Urethrovesical anastomosis was easily performed in all cases in the standard manner. Blood transfusion was needed in 2 patients (1 received 2 U and another 5 U of blood). The mean operative duration was 183 +/- 29.7 minutes (range, 150-240 minutes), the mean estimated blood loss was 656 +/- 576 mL (range, 100-2000 mL), and no deterioration of graft function was observed. All patients were followed, and the mean follow-up was 10.5 months (range, 2-30 months). Prostate-specific antigen was undetectable in all cases during this time frame.
  
  
  CONCLUSIONS
  Radical retropubic prostatectomy in renal transplant patients is safe, effective, and can be easily performed in the same manner as described by Walsh, regardless of the presence of the allograft. The only necessary technical modification is the avoidance of ipsilateral lymphadenectomy to prevent damage to the transplanted organ.
authors.affiliation: Division of Urology, Renal Transplant Unit, Hospital das Clínicas, University of São Paulo, São Paulo, Brazil. antonop@ig.com.br
authors.forename: Ioannis M
authors.initials: IM
authors.lastname: Antonopoulos
authors.forename: William C
authors.initials: WC
authors.lastname: Nahas
authors.forename: Affonso C
authors.initials: AC
authors.lastname: Piovesan
authors.forename: Renato
authors.initials: R
authors.lastname: Falci
authors.forename: Hideki
authors.initials: H
authors.lastname: Kanashiro
authors.forename: Gilberto A
authors.initials: GA
authors.lastname: Alvarez
authors.forename: Miguel
authors.initials: M
authors.lastname: Srougi
mesh_terms: D000368:Aged; D001803:Blood Transfusion; D005240:Feasibility Studies; D005500:Follow-Up Studies; D006801:Humans; D007674:Kidney Diseases / Q000150:complications* / Q000628:therapy*; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D017430:Prostate-Specific Antigen / Q000097:blood; D011468:Prostatectomy / Q000379:methods*; D011471:Prostatic Neoplasms / Q000150:complications* / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome; D013520:Urologic Surgical Procedures / Q000379:methods
chemical_list: D017430:Prostate-Specific Antigen