# Robot‐Assisted Cystoprostatectomy for Muscle‐Invasive Bladder Cancer in a Patient With a Prior Simultaneous Pancreas–Kidney Transplantation

## TL;DR

A patient with a prior pancreas-kidney transplant successfully underwent robot-assisted bladder cancer surgery.

## Contribution

Demonstrates the feasibility of robot-assisted cystoprostatectomy in transplant recipients.

## Key findings

- Robot-assisted surgery was safely performed in a pancreas-kidney transplant recipient.
- Bladder cancer in transplant patients can be aggressive and present with atypical symptoms.
- Intracorporeal ileal conduit was successfully used for urinary diversion.

## Abstract

Kidney transplant recipients are at increased risk of malignancy due to chronic immunosuppression. Although rare (≈0.3%), bladder cancer in this population tends to be aggressive and may present with atypical symptoms. We report a case of muscle‐invasive bladder cancer in a patient with prior simultaneous pancreas–kidney transplantation, successfully managed by fully intracorporeal robot‐assisted radical cystoprostatectomy and urinary diversion.

A 46‐year‐old male with a history of a simultaneous pancreas and kidney transplantation presented with persistent storage lower urinary tract symptoms. Cystoscopy revealed a necrotic, atypical lesion with associated inflammatory changes. Preoperative CT urography showed thickening of the bladder dome, with peripheral enhancement and a calcified component. The patient underwent robot‐assisted radical cystoprostatectomy with intracorporeal ileal conduit involving the transplanted kidney.

This rare case highlights the importance of thorough urological evaluation in transplant recipients presenting with atypical urinary symptoms.

This case demonstrates the feasibility and safety of fully intracorporeal robot‐assisted cystoprostatectomy with urinary diversion in a patient with a simultaneous pancreas–kidney transplant.