Robot-assisted Extravesical Intramural Ureterectomy for Upper Tract Urothelial Carcinoma to Avoid Bladder Cuff Excision

Radical nephroureterectomy with bladder cuff excision remains the gold standard for upper tract urothelial carcinoma (UTUC). While traditional approaches often mandate the removal of bladder cuff, though it does not defy the logic of removal of 1–2 cm of bladder cuff, we present a case series of 12 patients with renal pelvis and upper ureteric UTUC who had robot-assisted extravesical intramural ureterectomy without the removal of the bladder cuff. As the intramural ureter is the only blind spot for subsequent cystoscopy, all patients did well, with no recurrence at the site of the previously resected ureteric orifice, and the catheter could be removed at a median of 3 days.