Robot-assisted bladder diverticulectomy sequentially followed by robot-assisted radical prostatectomy: a case series.

We aimed to describe a case series of robot-assisted bladder diverticulectomy followed by radical prostatectomy for prostate cancer in a single surgical procedure. Three cases of robot-assisted bladder diverticulectomy and radical prostatectomy were completed between 2013 and 2016. Charts of the three cases were reviewed and analyzed for perioperative and postoperative outcomes. All patients presented with lower urinary tract symptoms, and bladder diverticulum or diverticula was revealed after further evaluation of the patients. In addition, elevated prostate-specific antigen levels were noted. All patients were diagnosed with prostate carcinoma on the basis of subsequent multiparametric MRI studies and biopsies. Three patients underwent da Vinci robot-assisted diverticulectomy followed by radical prostatectomy using a transperitoneal approach. All patients had Foley catheters removed postoperatively after negative cystogram, and no substantial complications were noted. Sequential robot-assisted bladder diverticulectomy-radical prostatectomy is an effective and safe procedure.

[Acute abducens nerve palsy following prostatitis due to prostate biopsy].

This is a case of repeated acute abducens nerve palsy following prostatitis due to prostate biopsy. A 64-year-old man came to our hospital because of high prostate specific antigen (PSA; 25 ng/ml) on routine medical examination. Transrectal prostate needle biopsy revealed atypical small acinar proliferations in two cores taken from the apex of the prostate. One day after biopsy, the patient presented with chills and a fever. Prostatitis due to prostate biopsy was diagnosed, and hydration and intravenous antibiotics were administered. Although he showed signs of improvement, seven days after biopsy, he complained of double vision in the left gaze. Upon referral to the neurology, head MRI and CSF examination showed no particular abnormality. He was thus diagnosed with post-infection abducens nerve palsy and treated with steroid therapy. His symptoms gradually ameliorated. One year after biopsy, his PSA level was still high, although follow-up prostate biopsy was benign. One day after follow-up biopsy, he presented again with chills and a fever. He was retreated with hydration and intravenous antibiotics. Six days after follow-up biopsy, he complained of double vision in the left gaze as in the previous year. With the diagnosis of post-infection abducens nerve palsy, he was retreated with steroid therapy.