Functional and Urodynamics Outcomes After Robot Assisted Cystoprostatectomy With Intra Corporeal Neobladder: Impact of the Learning Curve.

Robotic-assisted radical cystectomy (RARC) with intracorporeal orthotopic neobladder (iONB) is a technically demanding procedure with a steep learning curve. This study aims to evaluate the functional and urodynamic outcomes of iONB during the initial learning phase to understand its impact on patient quality of life and surgical performance. A retrospective cohort study was conducted at a high-volume tertiary center, analyzing 20 male patients who underwent RARC with iONB for bladder cancer between 2016 and 2021. Data collected included perioperative outcomes, complications, continence rates, and urodynamic parameters. Functional outcomes were assessed using patient questionnaires, and urodynamic assessment were performed on a subset of patients. The median follow-up was 23.8 months, and 75% of patients achieved continence (0-1 pad/day). None required self-catheterization, and urodynamic studies in four patients showed favorable capacity of 412.5 mL (IQR 360-512), with a median post-void residual of 5 mL.. Low-grade complications occurred in 65% of patients, while high-grade complications were observed in 35%. No intraoperative complications or conversions to open surgery were reported. RARC with iONB provides promising functional outcomes in the early learning phase. Further research with larger cohorts and controlled designs is needed to confirm these findings and optimize technique selection. LEVEL OF EVIDENCE : 4.