Robot-assisted supratrigonal cystectomy and augmentation cystoplasty for neurological bladder in adults: comparison of extracorporeal vs. intracorporeal diversion

You have accessJournal of UrologyCME1 Apr 2023MP52-18 ROBOT-ASSISTED SUPRATRIGONAL CYSTECTOMY AND AUGMENTATION CYSTOPLASTY FOR NEUROLOGICAL BLADDER IN ADULTS: COMPARISON OF EXTRACORPOREAL VS. INTRACORPOREAL DIVERSION Benoit Peyronnet, Pierre Lecoanet, Juliette Hascoet, Adil Mellouki, Branwell Tibi, Gregory Verhoest, Karim Bensalah, Andrea Manunta, and Imad Bentellis Benoit PeyronnetBenoit Peyronnet More articles by this author , Pierre LecoanetPierre Lecoanet More articles by this author , Juliette HascoetJuliette Hascoet More articles by this author , Adil MelloukiAdil Mellouki More articles by this author , Branwell TibiBranwell Tibi More articles by this author , Gregory VerhoestGregory Verhoest More articles by this author , Karim BensalahKarim Bensalah More articles by this author , Andrea ManuntaAndrea Manunta More articles by this author , and Imad BentellisImad Bentellis More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003300.18AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: There is very little data on robot-assisted supratrigonal cystectomy and augmentation cystoplasty (RASCAC) in adult neurological patients. The objective of this study was to compare the perioperative outcomes of RASCAC with extracorporeal (RASCAC-EXTRA) vs. intracorporeal (RASCAC-INTRA) diversion in adults. METHODS: The charts of all patients who underwent a RASCAC for neurogenic lower urinary tract dysfunction (NLUTD) between October 2015 and April 2021 in three centers were retrospectively reviewed. The diversion was done extracorporeally between 2015 and 2019 ù`and intracorporeally thereafter. The preoperative and 3 months postoperative assessments included bladder diaries. urodynamics and the ICIQ-SF. Qualiveen SF and USP questionnaires. The continence status postoperatively was categorized as complete continence (no pad). improved continence or unchanged continence RESULTS: Twenty patients were enrolled over the study period: seven RASCAC-EXTRA and 13 RASCAC-INTRA. Two conversions to an open approach were required in the RASCAC-EXTRA group (28.6% vs. 0%; p=0.04). The operative time was shorter in the RASCAC-INTRA group (306.2 vs. 432.9 min; p=0.006). The length of hospital stay was comparable in both groups (8.3 vs. 8.4 days; p=0.81). The rate of post-operative complications was comparabale in the RASCAC-INTRA and RASCAC-EXTRA groups (61.5% vs. 71.4%; p=0.99). Among these complications. Only three were Clavien ≥3 (15%), two in the RASCAC-INTRA group and one ni the RASCAC-EXTRA group (15.4% vs. 14.3%; p=0.99). The time to oral feeding and time to return of bowel function were significantly shorter in the RASCAC-INTRA group (2.3 vs. 4.1 days; p=0.03 and 2 vs. 4.4 days; p=0.02 respectively). The rates of complete continence at 3 months wer similar in both groups (75% vs. 57.1%; p=0.31). CONCLUSIONS: Robot-assisted supratrigonal cystectomy and augmentation cystoplasty appears to be technically feasible in adult neurological patients. The perioperative outcomes were mostly comparable in the intracorporeal and extracorporeal groups but there was a shorter operative time and shorter times to oral feeding and return of bowel function in the RASCAC-INTRA group. Source of Funding: none © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e709 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Benoit Peyronnet More articles by this author Pierre Lecoanet More articles by this author Juliette Hascoet More articles by this author Adil Mellouki More articles by this author Branwell Tibi More articles by this author Gregory Verhoest More articles by this author Karim Bensalah More articles by this author Andrea Manunta More articles by this author Imad Bentellis More articles by this author Expand All Advertisement PDF downloadLoading ...