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Robotic reconstruction of complex bladder neck stenosis: Single-centre experience with three techniques
Emily Rinderknecht1, Simon Udo Engelmann1, Veronika Saberi1
1Department of Urology, St. Josef Medical Center University of Regensburg Regensburg Germany.
BJUI Compass
|February 24, 2025
Summary
Robot-assisted bladder neck reconstruction for recurrent stenosis shows YV plasty is preferred. This technique offers lower complication and failure rates compared to stricture resection or buccal mucosa grafts.
Area of Science:
- Urology
- Surgical Oncology
- Robotic Surgery
Background:
- Recurrent bladder neck stenosis (BNS) after prostatectomy is a rare but challenging urologic condition.
- Various robotic reconstructive techniques exist with differing success rates.
Purpose of the Study:
- To evaluate and compare surgical techniques for robot-assisted reconstruction of recurrent BNS.
- To identify the most effective and safest robotic approach for managing recurrent BNS.
Main Methods:
- Retrospective analysis of 27 patients undergoing robot-assisted repair for recurrent BNS.
- Comparison of three techniques: YV plasty, stricture resection with anastomosis, and buccal mucosa graft (BMG).
- Analysis of clinical data, complications (Clavien-Dindo), and follow-up outcomes.
Main Results:
- Therapy failure occurred in 33.3% of patients (YV plasty 25.0%, stricture resection 33.3%, BMG 66.7%).
- Complications occurred in 33.3% of patients, with stricture resection having the highest rate.
- De novo incontinence occurred in 19.2% of patients, exclusively in the stricture resection group.
Conclusions:
- Recurrent BNS is a significant surgical challenge.
- BMG reconstruction showed suboptimal outcomes; stricture resection had the highest complication and incontinence rates.
- YV plasty is a preferred technique due to its low morbidity and minimally invasive nature.
