Perioperative and Short-Term Outcomes of Robotic vs Open Bladder Neck Procedures for Neurogenic Incontinence

Gwen M. Grimsby, Micah A. Jacobs, Vani Menon, Bruce J. Schlomer, Patricio C. Gargollo

Research output: Contribution to journalArticlepeer-review

13 Scopus citations

Abstract

Purpose Complex urological reconstruction may be facilitated by the improved magnification and dexterity provided by a robotic approach. Minimally invasive surgery also has the potential advantages of decreased length of stay and improved convalescence. We reviewed perioperative and short-term outcomes between robot-assisted and open bladder neck sling/repair with catheterizable channel in patients with neurogenic bladder. Materials and Methods We performed an institutional review board approved retrospective chart review of all patients who underwent open or robotic bladder neck reconstruction without augmentation cystoplasty for refractory urinary incontinence between 2010 and 2014. Age at surgery, operative time, length of stay, complications within 30 days of surgery and future continence procedures (injection of bladder neck/catheterizable channel, additional bladder neck surgery, botulinum toxin A injection) were compared between the groups. Results A total of 45 patients underwent bladder neck reconstruction (open in 26, robotic in 19) with a mean follow up of 2.8 years. There was no difference in preoperative urodynamics, age at surgery or length of stay (median 4 days in each group, p >0.9). Operative time was significantly longer in the robotic group (8.2 vs 4.5 hours, p <0.001). Three patients (16%) undergoing robotic and 3 (12%) undergoing open surgery had a complication within 30 days (p >0.9). Of patients undergoing open repair 14 (56%) underwent 23 subsequent surgeries for incontinence. By comparison, 8 patients undergoing robotic repair (42%) underwent 12 additional procedures (p = 0.5). Conclusions Although a robotic approach may take longer to perform, it does not result in increased complications or length of stay, or worsened continence outcomes.

Original languageEnglish (US)
Pages (from-to)1088-1092
Number of pages5
JournalJournal of Urology
Volume195
Issue number4
DOIs
StatePublished - Apr 2016

Keywords

  • neurogenic
  • robotics
  • spinal dysraphism
  • urinary bladder
  • urinary incontinence

ASJC Scopus subject areas

  • Urology

Fingerprint

Dive into the research topics of 'Perioperative and Short-Term Outcomes of Robotic vs Open Bladder Neck Procedures for Neurogenic Incontinence'. Together they form a unique fingerprint.

Cite this