title: Salvage robotic-assisted laparoscopic radical prostatectomy following failed primary high-intensity focussed ultrasound treatment for localised prostate cancer.
abstract: We report the first case of salvage robotic-assisted laparoscopic radical prostatectomy (RALP) following failed primary high-intensity focussed ultrasound (HIFU) for localised carcinoma of the prostate. A 66-year-old male with a presenting prostate-specific antigen (PSA) of 5 ng/ml was diagnosed with T1c Gleason 3 + 4 prostate cancer. He underwent transurethral resection of the prostate and HIFU. His PSA dropped to 2.0 ng/ml and repeat biopsy revealed upgrading of his prostate cancer to Gleason 4 + 3. He was referred to us for a second opinion and, following discussion of his options, he underwent RALP. The total operative time was 159 min. There were no intra- or postoperative complications. He was discharged on postoperative day two and was fully continent 10 days following removal of his catheter. His PSA remained undetectable 6 months postoperatively. Salvage RALP was feasible in this case with good functional and short-term oncological outcomes for the patient.
authors.affiliation: Department of Urology, Epworth Hospital, Richmond, Australia. decmurphy@doctors.net.uk.|Department of Urology, Royal Melbourne Hospital, Grattan Street, Parkville, VIC, 3052, Australia. decmurphy@doctors.net.uk.
authors.forename: Declan G
authors.initials: DG
authors.lastname: Murphy
authors.affiliation: Department of Histopathology, TissuPath Histopathology and Cytogenetic Services, Melbourne, Australia.
authors.forename: John
authors.initials: J
authors.lastname: Pedersen
authors.affiliation: Department of Urology, Epworth Hospital, Richmond, Australia.|Department of Urology, Royal Melbourne Hospital, Grattan Street, Parkville, VIC, 3052, Australia.
authors.forename: Anthony J
authors.initials: AJ
authors.lastname: Costello
keywords: HIFU; High-intensity focussed ultrasound; Laparoscopic; Prostate cancer; Radical prostatectomy; Robotic; Salvage; da Vinci