Robot-assisted radical cystectomy using real-time transrectal ultrasound guidance in a patient who had radical prostatectomy and salvage external beam radiation therapy

IntroductionRadical cystectomy for patients who previously underwent both radical prostatectomy and prostatic bed radiation is technically challenging.Case presentationA 78-year-old man with a history of radical prostatectomy and salvage radiation for prostate cancer was referred to our hospital for radical treatment of bladder cancer. After two cycles of neoadjuvant chemotherapy, he underwent robot-assisted radical cystectomy with real-time transrectal ultrasound guidance during dissection of the rectovesical space to minimize the risk of rectal injury. There were no perioperative adverse events.ConclusionIntraoperative real-time transrectal ultrasound guidance could assist surgeons to safely perform the dissection of the rectovesical space in the surgically high-risk patient.