Feasibility and mid-term outcomes of simultaneous robot-assisted laparoscopic radical prostatectomy and transurethral resection of bladder tumor: a single-center case series

Abstract

To describe the feasibility and mid-term outcomes of simultaneous robot-assisted laparoscopic radical prostatectomy (RALP) and transurethral resection of bladder tumor (TURB) in patients with localized prostate cancer and concomitant non–muscle-invasive bladder cancer (NMIBC). We retrospectively reviewed patients who underwent simultaneous RALP and TURB between 2020 and 2023. Candidates had clinically localized prostate cancer and cystoscopically visible papillary Ta/T1 NMIBC without carcinoma in situ. Patients with findings suspicious for muscle-invasive bladder cancer on preoperative magnetic resonance imaging were excluded. Clinicopathologic characteristics, postoperative findings, and intravesical recurrence were summarized descriptively. Twelve men were included. Median age was 69 years (interquartile range, 64.75–74.00). Bladder tumors were solitary in 10 patients (83.3%) and measured 1–3 cm in 9 (75.0%). Pathologic grade was low in 11 patients (91.7%), and no patient had carcinoma in situ. Pathologic stage was Ta in 10 patients (83.3%) and T1 in 2 (16.7%). Postoperative intravesical therapy consisted of gemcitabine in 8 patients (66.7%) and bacillus Calmette–Guérin in 4 (33.3%). For prostate cancer, 6 patients (50.0%) were classified as high risk according to NCCN criteria (Version 4.2023), and 1 patient (8.3%) had a positive surgical margin. Median length of hospital stay and catheter duration were both 7 days. Cystography on postoperative day 7 showed no urinary leakage. No postoperative complications or readmissions occurred. During a median follow-up of 48 months, no intravesical recurrence or progression to muscle-invasive bladder cancer was observed. In this small, highly selected case series, simultaneous RALP and TURB was technically feasible, with no observed intravesical recurrence during mid-term follow-up. These findings should be interpreted as preliminary descriptive data rather than evidence of oncological equivalence to staged management.