Robotic-Assisted Seminal Vesicle Excision vs Brachytherapy for Isolated Seminal Vesicle Recurrence: 2 Case Reports

Abstract The most common treatment for isolated seminal vesicle recurrence (ISVR) has been androgen deprivation therapy (ADT). Prior to the introduction of prostate-specific membrane antigen PET (PSMA-PET), detecting ISVR was imprecise, with most patients treated with ADT in the setting of biochemical failure. However, with the advent of high-sensitivity and -specificity PSMA-PET, identifying patients with ISVR is now possible, and local therapy may potentially offer cure with acceptable morbidity. We present 2 cases of ISVR treated with robotic-assisted seminal vesicle excision (RASVE) vs low-dose-rate (LDR) salvage brachytherapy, both of which rendered the patients disease free with undetectable prostate-specific antigen with short-term follow-up. RASVE and LDR salvage brachytherapy are reasonable treatment options for ISVR, with curative intent.