Robotic Y-V Plasty for Recalcitrant Bladder Neck Contracture

Area of Science:

• Urology
• Minimally Invasive Surgery
• Robotic Surgery

Background:

• Recalcitrant bladder neck contracture (BNC) presents a significant reconstructive challenge.
• Previous endoscopic management often fails, necessitating advanced surgical techniques.

Purpose of the Study:

• To demonstrate the technique and outcomes of robot-assisted Y-V plasty bladder neck reconstruction (RYVBNR).
• To evaluate the efficacy of RYVBNR in patients with complex BNC.

Main Methods:

• RYVBNR was performed on 7 patients with recalcitrant BNC or vesicourethral anastomotic stenosis.
• The technique involves robotic dissection, Firefly technology for localization, and a Y-V plasty advancement flap.
• Perioperative management included a closed suction drain and a 22 Fr catheter.

Main Results:

• All 7 patients underwent successful RYVBNR without conversion to open surgery.
• Median operative time was 240 minutes with minimal blood loss (67 mL) and a 1-day hospital stay.
• At a median follow-up of 8 months, all cases showed no recurrence, with only 2 patients experiencing mild urinary incontinence.

Conclusions:

• Robot-assisted Y-V plasty bladder neck reconstruction is a feasible and effective surgical option.
• This technique successfully addresses difficult reconstructive problems associated with BNC.
• RYVBNR offers a minimally invasive approach with high success rates and low complication rates.