Robot-Assisted Radical Cystectomy for Invasive Bladder Cancer With Vesicovaginal Fistula: A Case Report

An 89-year-old woman was diagnosed with vesicovaginal fistula (VVF) during transurethral surgery for repeated bladder cancer recurrences. She was referred to our hospital for the treatment of VVF and pT1 invasive bladder cancer. Typical radical cystectomy procedures incising the vaginal wall are not suitable for her because of the high risk of disseminating tumors. Robot-assisted radical cystectomy with en bloc resection of the bladder, uterus, ovaries, and vagina was successfully performed without urine extravasation by dissecting the rectovaginal space to the pelvic floor, referencing the robot-assisted sacrocolpopexy technique. No evidence of recurrence was noted within 10 months after surgery.