Robot-Assisted Radical Cystectomy (RARC) and Intracorporeal Studer Neobladder: Surgical Technique, Feasibility, and...

Radical cystectomy can be associated with a high risk of perioperative morbidity and an impact on urinary continence and sexual function. Different techniques of intracorporeal urinary diversion (ICUD) have been described with the aim of improving the postoperative functional outcome. We will talk about our experience in robot-assisted radical cystectomy (RARC) and ICUD.

This is a retrospective study including patients who underwent RARC and intracorporeal Studer neobladder. The oncological outcomes were assessed during the follow-up with a CT CAP that was done at 6, 12, and 24 months. Urinary continence was assessed at 12 months postoperatively. The number of pads was recorded separately for the daytime and nighttime. In case of hypercontinence, frequency of clean intermittent self-catheterization was recorded as well.

A total of 12 patients were included in our study. Our data showed that neobladder configuration resulted in a longer operative time, but this was not associated with a higher complication rate or length of hospital stay. Most of the patients (91%) were continent during the day and used 0-1 pad only, also a large proportion of the patients (63.6%) achieved good nighttime continence and used 0-1 pad only during the night. Daytime hypercontinence was reported in 45.4% of patients and nighttime hypercontinence was reported in 27.2% of patients.

While RARC and neobladder are complex procedures that require specialized surgical expertise, they are technically feasible, safe and can offer hope for patients with bladder cancer to have a more natural and functional alternative to the traditional ileal conduit.