Open versus robot-assisted surgery in reconstructive urology: lessons from vesicourethral anastomotic stenosis and radical cystectomy

Open surgery remains the standard for perineal and external genital reconstructive procedures, whereas robot-assisted approaches are best suited for transabdominal reconstructions. Deep vesicourethral anastomotic stenoses involving the external sphincter should be managed through an open transperineal approach. Notably, during the decade of widespread robotic adoption, the rate of continent urinary diversions has declined significantly.