Robotic-assisted bladder neck procedures in children with neurogenic bladder
- 45 Downloads
To review the current status of robotic-assisted laparoscopic surgical techniques for bladder neck procedures in children with incontinence secondary to neurogenic bladder.
A comprehensive review of the literature on robotic-assisted bladder neck procedures was conducted, with a focus on articles published in the last 25 years. These data were subsequently compared to published series of open bladder neck procedures and published results from robotic-assisted bladder neck reconstruction series completed at our institution.
The principle bladder neck procedures for incontinence in pediatric patients with neurogenic bladder include: Artificial Urinary Sphincter, Bladder Neck Sling, Bladder Neck Closure, and Bladder Neck Reconstruction. Continence rates range from 60 to 100% with a lack of expert consensus on the preferred procedure (or combination of procedures). Robotic-assisted approaches are associated with longer operative times, especially early in the surgical experience, but demonstrate equivalent continence rates with potential benefits including low interoperative blood loss, improved cosmesis, and decreased intra-abdominal adhesion formation.
Robotic-assisted procedures of the bladder neck are safe, feasible, follow the same steps and principles as those of open surgery and produce equivalent continence rates. Robotic-assisted techniques can be adapted to a variety of bladder neck procedures and safely expanded to selected patients with the previous open abdominal surgery.
KeywordsNeurogenic bladder Robotic-assisted surgery Bladder neck reconstruction Artificial urinary sphincter Bladder neck sling Bladder neck closure
Artificial Urinary Sphincter
Bladder Neck Closure
Bladder Neck Reconstruction
Bladder Neck Sling
Clean Intermittent Catheterization
Previous open abdominal surgery
Robotic-assisted laparoscopic artificial urinary sphincter
Robotic-assisted laparoscopic surgery
PCG: protocol/project development, data analysis, and manuscript editing. LAW: data collection, data analysis, and manuscript writing/editing.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
Research involving human participants and/or animals
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.
Informed consent was obtained from all individual participants included in the study.