Intravesical fungus ball following robot-assisted radical prostatectomy in diabetes mellitus patient

Introduction

A case with a rare complication considered to be related to a robot-assisted radical prostatectomy procedure and medication given thereafter is presented.

Case presentation

A 73-year-old male diagnosed with prostate cancer underwent a robot-assisted radical prostatectomy and lymphadenectomy. The medical history included type II diabetes mellitus managed with canagliflozin hydrate. Six months after the operation, the patient was affected by pneumaturia and soft yellowish tissue discharge during micturition. Candida species were detected in urine and soft tissue cultures. Based on a diagnosis of intravesical fungus ball, a transurethral resection was performed. It was considered that partial impairment of vesical blood supply caused by clamping of a branch of the inferior vesical artery during the lymphadenectomy procedure likely contributed to intravesical fungus ball formation.

Conclusion

Awareness of the various arteries supplying vesical blood flow and urogenital infection following sodium-glucose cotransporter-2 inhibitor administration can be beneficial for the attending surgeon.