Robotic Mainz II pouch for restoring continence and volitional voiding in failed exstrophy-epispadias complex

A 17-year-old male and a 30-year-old female with bladder exstrophy-epispadias complex and failed primary repair during infancy presented with continuous urinary leakage and an open bladder plate. Considering their age and desire to avoid a stoma and catheterization, a Mainz II continent urinary diversion was performed with robotic assistance. The ureters were implanted into an S-shaped, low-pressure, high-capacity sigmoid pouch using an extramural serosal tunnel technique to create an anti-refluxing anastomosis. At 3-month follow-up, both patients were completely continent, able to hold urine for 3-4 h, with preserved renal function. The male had preserved erectile function.