title: Symphysiotomy: a valuable approach in children with prostate rhabdomyosarcoma.
abstract: Surgery for large prostate rhabdoyasarcoma in children is a challenging procedure. We discussed the value of pubic symphysiotomy in affected patients. The symphysiotomy approach was used in two children with a large rhabdomyosarcoma of the prostate. In each case, the initial exposure was obtained through a lower midline incision, but, due to technical difficulties, resulting from the size of the tumor, surgery was completed via a symphysiotomy approach. In each case, the bladder was preserved and a radical prostatectomy was facilitated by the excellent exposure provided by the symphysiotomy. The patients have been followed for 6 years and 26 months, respectively. Both are tumor free. Neither has developed orthopedic complications. In conclusion, the symphysiotomy approach, for large prostate rhabdomyosarcoma in children, results in an excellent surgical exposure, thus, facilitating the performance of a radical prostatectomy with bladder preservation. Orthopedic complications have not developed throughout the follow up period.
authors.affiliation: Section of Pediatric Urology, Department of Pediatric Surgery, MassGeneral Hospital for Children, Boston, USA. rpieretti@partners.org
authors.forename: Rafael V
authors.initials: RV
authors.lastname: Pieretti
authors.forename: Daniel P
authors.initials: DP
authors.lastname: Ryan
authors.forename: Alberto
authors.initials: A
authors.lastname: Pieretti
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001706:Biopsy; D003131:Combined Modality Therapy; D003937:Diagnosis, Differential; D006801:Humans; D007223:Infant; D008279:Magnetic Resonance Imaging; D008297:Male; D011471:Prostatic Neoplasms / Q000175:diagnosis / Q000188:drug therapy / Q000601:surgery*; D012208:Rhabdomyosarcoma / Q000175:diagnosis / Q000188:drug therapy / Q000601:surgery*; D013567:Symphysiotomy / Q000379:methods*