title: Robot-assisted laparoscopic prostatectomy in patients with preexisting three-piece inflatable penile prosthesis.
abstract: BACKGROUND
  Robotic-assisted laparoscopic radical prostatectomy (RARP) is becoming the preferred surgical treatment option for management of organ-confined prostate cancer. Although not a contraindication, previous pelvic surgery can make RARP challenging. Presence of a three-piece inflatable penile prosthesis, with a perivesical pelvic reservoir, has the potential to induce steric hindrance making RARP difficult.
  
  
  OBJECTIVE
  The main purpose of this publication is to report our experience with RARP in patients with previously inserted three-piece inflatable penile prostheses.
  
  
  METHODS
  Two patients with previously inserted AMS 700 penile prosthesis and with organ-confined, biopsy proven adenocarcinoma of the prostate underwent RARP. We describe intraoperative findings, surgical technique, oncologic and functional outcomes.
  
  
  RESULTS
  Both patients underwent safe and successful RARP with out any complications. Surgical margins were not affected with pelvic reservoir-sparing technique. In both patients, the penile prosthesis remained functional postoperatively.
  
  
  CONCLUSIONS
  RARP can be safely performed in patients with previously inserted three-piece inflatable penile prosthesis. Nontraumatic handling of the pelvic reservoir is mandatory to preserve prosthesis' integrity.
authors.affiliation: Department of Surgery, Division of Urology, Schulich School of Medicine & Dentistry, The University of Western Ontario, London, Canada.
authors.forename: Petar
authors.initials: P
authors.lastname: Erdeljan
authors.forename: Gerald
authors.initials: G
authors.lastname: Brock
authors.forename: Stephen E
authors.initials: SE
authors.lastname: Pautler
mesh_terms: D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D015917:Penile Prosthesis; D011468:Prostatectomy / Q000295:instrumentation* / Q000379:methods; D011471:Prostatic Neoplasms / Q000601:surgery; D012371:Robotics