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

Introduction 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. Presentation 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. Clinical Discussion This rare case highlights the importance of thorough urological evaluation in transplant recipients presenting with atypical urinary symptoms. Conclusion 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.