V13-08 Robot-Assisted Trans-Vesical Anterior Inlay of Buccal Mucosal Graft for Recurrent Bladder Neck Contracture

You have accessJournal of UrologyLower Tract Reconstruction (including Transgender) II (V13)1 May 2024V13-08 ROBOT-ASSISTED TRANS-VESICAL ANTERIOR INLAY OF BUCCAL MUCOSAL GRAFT FOR RECURRENT BLADDER NECK CONTRACTURE Lucas Freton, Lee Zhao, Vivien Graffeille, Claire Richard, Juliette Hascoet, Antoine Jeanne-Julien, Andrea Manunta, Romain Mathieu, Karim Bensalah, and Benoit Peyronnet Lucas FretonLucas Freton , Lee ZhaoLee Zhao , Vivien GraffeilleVivien Graffeille , Claire RichardClaire Richard , Juliette HascoetJuliette Hascoet , Antoine Jeanne-JulienAntoine Jeanne-Julien , Andrea ManuntaAndrea Manunta , Romain MathieuRomain Mathieu , Karim BensalahKarim Bensalah , and Benoit PeyronnetBenoit Peyronnet View All Author Informationhttps://doi.org/10.1097/01.JU.0001009532.52598.9a.08AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: There is no clear consensus regarding the management of recurrent bladder neck contracture (BNC) after endoscopic treatment. The purpose of this video was to describe a robotic transvesical buccal mucosal graft urethroplasty technique for recurrent BNC after a first robotic YV plasty. METHODS: The technique is described in the video. This is a 73-year-old man who had benign prostatic hypertrophy treated with monopolar transurethral resection of the prostate (TURP) in 2007 and then had 3 endoscopic treatments (monopolar RTUP, monopolar transurethral incision of BNC, and holmium laser urethrotomy) combined with self-dilations in 2019. He had a robotic YV plasty in March 2020 for a BNC recurrence. He had an urinary tract infection in the post-operative course and had worsening of symptoms 9 months after surgery with mixed symptoms and recurrence of post-void residual at 180cc. The fibroscopy showed a anterior recurrence. RESULTS: The operation was performed under general anesthesia in 23° Trendelenburg position. The Xi robot is docked and 5 ports are placed. A transperitoneal approach is used and the bladder is wide opened longitudinally. The edges are fixed to the abdominal wall. The contracture is incised anteriorly and the fibrosis is removed. A buccal mucosa graft is then fixed in a running fashion. The graft is fixed with fast-absorbing suture. The bladder is closed and a methylene blue test is performed. The patient was discharged at postoperative day 1. The urethral catheter was removed at day 14. There were no postoperative complications. At 12 months, there was no recurrence of stricture and the patient had 25cc PVR. CONCLUSIONS: Robotic trans-vesical buccal mucosa graft for recurrent cervical sclerosis is a feasible technique that seems provide satisfactory results as a revision procedure in patients with recurrent contracture after endoscopic treatment and YV plasty. Long-term follow-up will be necessary to evaluate functional results. Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e1158 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Lucas Freton More articles by this author Lee Zhao More articles by this author Vivien Graffeille More articles by this author Claire Richard More articles by this author Juliette Hascoet More articles by this author Antoine Jeanne-Julien More articles by this author Andrea Manunta More articles by this author Romain Mathieu More articles by this author Karim Bensalah More articles by this author Benoit Peyronnet More articles by this author Expand All Advertisement PDF downloadLoading ...