CASE REPORT
Robotic Prostatectomy for a 390 g Recurrent Prostate Leiomyoma
Reoperative robotic excision of a massive recurrent benign prostatic mass in a patient with a prior transurethral resection of the prostate (TURP), a urethral stricture, and a non-functioning kidney.
Procedure performed by Dr. Aditya Parikh
Patient Age
48 Years
Hospital Stay
3 Days
Recurrent Prostate Mass Weight
390 gm
Time to ambulation post-op
1 Day
Clinical history
A 48-year-old man presented with a complex urological history. Two years earlier, he had undergone a transurethral resection of the prostate (TURP) elsewhere for a 200 g prostate. He subsequently developed an aggressive 390 g recurrence of a prostate leiomyoma (a benign smooth-muscle tumour), together with a urethral stricture and a left non-functioning kidney secondary to prior stone disease and related surgery. The resulting severe bladder outlet obstruction left him fully dependent on daily clean intermittent catheterization (CIC) to empty his bladder. Given the size of the recurrence, the distorted anatomy from his previous surgery, and the coexisting stricture, he was referred for robotic simple prostatectomy.
Surgical and postoperative course
The surgical team evaluated the distorted pelvic anatomy from the prior TURP, the urethral stricture, and the extensive vascularity of the recurrent mass to plan a safe robotic approach.
The 390 g recurrent leiomyoma was excised robotically, requiring meticulous dissection to navigate scarred tissue planes and control bleeding from the highly vascular mass.
The patient was ambulatory on postoperative day 1 and discharged on postoperative day 3 with a suprapubic catheter (SPC) and a per-urethral catheter in place.
Both catheters were removed on postoperative day 9, after which the patient voided spontaneously.
Outcome
Following catheter removal, the patient achieved complete voiding with a normal, healthy urinary flow, marking a full functional recovery from what had been a severe, catheter-dependent bladder outlet obstruction.