V13-07 Single Port Robotic Transvesical Repair of Bladder Neck Contracture

You have accessJournal of UrologyLower Tract Reconstruction (including Transgender) II (V13)1 May 2024V13-07 SINGLE PORT ROBOTIC TRANSVESICAL REPAIR OF BLADDER NECK CONTRACTURE Courtney Yong and Ethan Ferguson Courtney YongCourtney Yong and Ethan FergusonEthan Ferguson View All Author Informationhttps://doi.org/10.1097/01.JU.0001009532.52598.9a.07AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The single port robot has been shown to have utility in the transvesical space for simple and radical prostatectomy. This video shows a single port, transvesical approach to a bladder neck contracture repair. The patient is a 66 year old male with a history of BPH and two prior TURPs. He developed a bladder neck contracture and underwent an incision of the bladder neck. However, his symptoms returned, and he went into retention requiring indwelling catheterization. Cystoscopy showed a short, 16 Fr bladder neck contracture. He elected for a robotic bladder neck contracture repair. METHODS: The repair was performed with the single port robot using the transvesical approach. We exchanged his indwelling catheter and made a 3 cm suprapubic incision, about 1.5 cm superior to the pubic bone. We accessed the space of Retzius through the midline, filled the bladder, and made a small cystotomy. The access port was placed directly into the bladder. We dissected circumferentially around the contracture and carried the dissection distally toward the urethra. We excised the contracture once we had reached the verumontanum. The urothelium was advanced down to the urethra using two running 3-0 stratafix sutures. A catheter was placed, the bladder was closed in two layers, and the fascia was closed. RESULTS: The procedure time was 106 minutes with 55 minutes of console time and little blood loss. The pathology showed urothelium with inflammation and fibrosis. The patient was discharged postoperatively with an indwelling catheter, which was removed on post operative day 6. The patient was able to void to completion. At one month follow up, he was continent. Cystoscopy at that time showed a patent, healing bladder neck and healing cystotomy closure. CONCLUSIONS: The transvesical approach using the single port robot is a minimally-invasive option for repair of bladder neck contracture. While this patient had a short stricture, longer or denser strictures may require more complex reconstruction such as Y-V-plasty or even prostatectomy. However, the single port robot would also facilitate these intraoperative adjustments. Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e1157 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Courtney Yong More articles by this author Ethan Ferguson More articles by this author Expand All Advertisement PDF downloadLoading ...