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Purpose: Kidney transplant recipients (KTRs) are at high risk for de novo malignancies, and the incidence of prostate cancer (PCa) is about 2-fold higher in these patients than in the general population. Laparoscopic radical prostatectomy (LRP) is an accepted minimally invasive treatment for organ-confined PCa. However, the procedure is challenging in KTRs because of the potential risk of allograft and ureteral injury. In this study, we report our experience with LRP in patients following kidney transplantation. Methods: Between 2006 and 2013, 234 consecutive LRPs were performed at Tokyo Women’s Medical University Hospital. We report the outcomes for three patients with prior renal transplants who underwent retroperitoneal LRP. Results: the mean age of the patients was 56.3 years. The average operative time was 236 min (range, 180–315 min). The mean estimated blood loss was 54.6 mL, with no patients requiring blood transfusions. Although tension-free urethrovesical anastomosis was achieved in every patient, anastomotic leakage occurred in two patients. The average hospital stay was 18.3 days, and the mean duration of urethral catheterization was 21 days. Serum creatinine levels remained unchanged in two patients who had functioning renal allografts. The third patient commenced hemodialysis postoperatively and resumed a continuous ambulatory peritoneal dialysis regimen two weeks after the operation. Conclusion: Although technically challenging, retroperitoneal LPR remains an effective treatment option for localized PCa in patients who have undergone kidney transplantation.

Management of Localized Prostate Cancer by Retroperitoneal Laparoscopic Radical Prostatectomy in Patients after Kidney Transplantation