Urothelial Carcinoma Recurrence in an Ileal Orthotopic Neobladder 10 Years After Primary Robotic Radical Cystoprostatectomy.

The recurrence of urothelial carcinoma in orthotopic ileal neobladder is an extremely rare entity. We present a case of a patient who developed urothelial carcinoma in a robotically formed ileal neobladder (Studer), 10 years after primary surgery, who was managed with robotic neocystectomy. A 56 year-old patient presented with gross hematuria 10 years after robotic cystoprostatectomy, lymphadenectomy, and intracorporeal formation of Studer ileal neobladder. After surgery the patient was closely followed up using cytology testing, cystoscopy, and imaging at regular intervals. Ten years later the patient presented gross hematuria. Cystoscopic examination with biopsies was performed, revealing the presence of high-grade urothelial carcinoma. The patient under general anesthesia was placed in a position similar to robotic prostatectomy and robotic neocystectomy with bilateral ureterostomy was performed. Although urothelial carcinoma in an orthotopic neobladder is unusual, recurrence should be considered in patients with hematuria who underwent radical cystoprostatectomy and orthotopic ileal neobladder formation. However, those patients can be managed safely and effectively, performing robotic neocystectomy.