Robotic assisted proximal dorsal urethral diverticulectomy

Area of Science:

• Urology
• Minimally Invasive Surgery
• Female Pelvic Medicine

Background:

• Urethral diverticula are uncommon but significant conditions in women.
• Dorsal urethral diverticula, especially proximal ones, pose surgical challenges due to anatomical location.
• Traditional transvaginal repair may be difficult for complex dorsal diverticula.

Purpose of the Study:

• To present a novel surgical technique for a complex urethral diverticulum.
• To evaluate the feasibility and outcomes of robot-assisted laparoscopic excision for a proximal dorsal urethral diverticulum.

Main Methods:

• Literature review of surgical techniques for urethral diverticula.
• Demonstration of a transabdominal robot-assisted laparoscopic excision technique.
• Case presentation of a large, proximal, dorsal urethral diverticulum with associated urosepsis.

Main Results:

• Successful robotic-assisted excision completed in 3 hours and 27 minutes with minimal blood loss (50 cc).
• Uneventful postoperative recovery with a well-healed repair confirmed by voiding cystourethrogram.
• Absence of new lower urinary tract symptoms at 6-month follow-up.

Conclusions:

• Robot-assisted urethral diverticulectomy is a viable option for challenging proximal dorsal urethral diverticula.
• Laparoscopic approaches can be adjuncts to standard vaginal repair for complex cases.
• This technique addresses the surgical difficulties associated with dorsal and proximal urethral diverticula in women.