A case of TURBT after penile prosthesis implantation

Abstract

The patient was a 66-year-old man who had undergone implantation of a penile prosthesis for organic erectile dysfunction 7 years prior to consulting our hospital with a complaint of gross hematuria. Since a pedunculated, superficial tumor 1 cm in diameter was noted lateral to the left ureteral orifice, transurethral resection of the bladder tumor (TURBT) was performed. In this patient, we were able to insert the sheath with no difficulty, and the surgical procedure was done smoothly, resulting in complete resection of the tumor. However, the location of the tumor in the anterior or posterior wall of the bladder predicted difficulty of the tumor resection. Therefore, we consider it important to sufficiently evaluate the feasibility of complete TURBT before surgery and to thoroughly examine the patient for benign prostatic hyperplasia and bladder cancer, which can cause difficulty with post-implantation ransurethral procedures, and to perform transurethral surgery before implantation, if prosthesis implantation is planned.

症例は66歳, 男性.7年前に器質性勃起不全のため, 陰茎プロステーシス移植術を受けていた.肉眼的血尿を訴え来院.左尿管口外側に径1cm大の有茎性表在性腫瘍を認めたため, 経尿道的膀胱腫瘍切除術(TURBT)を施行した.本症例に対しては, シースはとくに支障なく挿入可能であり, 手術操作もスムーズに行え, 腫瘍の完全切除が可能であったが, 腫瘍の存在位置が膀胱前壁や後壁の場合には腫瘍切除の困難が予想された.そのため, プロステーシス移植後のTURBTに対しては, 完全切除できるかを術前に十分評価を行うこと, また, プロステーシス移植を予定した場合, 移植後に経尿道的操作に支障をきたすことがあり得るため, 前立腺肥大症, 膀胱癌などの存在を精査し, 移植前に経尿道的手術を行っておくことが重要であると考えられた(著者抄録)