Search

Abstract Objectives To show that robot‐assisted laparoscopic cutaneous continent urinary diversion (RALCCUD) is feasible and safe; however, data on clinical outcomes in adults are lacking. Materials and methods We conducted a retrospective study of all adults who underwent RALCCUD between 2017 and 2022 at a single tertiary reference centre. Patient characteristics, clinical information and perioperative outcomes were recorded. All patients underwent pre‐ and postoperative urodynamic evaluations. Functional outcomes were evaluated at 3 months, then yearly. Continence was defined as no stomal or urethral leakage. Results Twelve patients, mostly women (n = 11), median (IQR) age 47.4 (19–57) years underwent RALCCUD (four Mitrofanoff, four Yang‐Monti and four Casale). The main indication for surgery was inability to perform intermittent self‐catheterization through the native urethra. Eleven patients (92%) had neurogenic lower urinary tract disease caused by spinal cord injury or spinal dysraphism. Median (IQR) operative time was 313 (285–367) min. Four patients (33%) underwent concomitant procedures: three supratrigonal cystectomy (SC) with augmentation cystoplasty (AC) and one artificial urinary sphincter (AUS). No conversions to an open approach were required. Median (IQR) follow‐up was 51 (40–61) months. One early postoperative complication occurred (Clavien grade III). The late postoperative complication rate was 17%, with three complications occurring in three patients. At the last follow‐up, all patients could self‐catheterize through the tube, and the stomal and urethral continence rate was 100%. Conclusion RALCCUD is feasible and safe in adults, with a high rate of stomal and urethral continence and a low complication rate.

Abstract Purpose The primary aim of this study was to evaluate the indications and additional information provided by videourodynamic study (VUDS) over urodynamic studies (UDS) in men with spinal cord injury (SCI) and neurogenic lower urinary tract dysfunction (NLUTD). The secondary aim was to determine the added value of VUDS and its impact on bladder management. Materials and Methods Single‐centre retrospective study of all men with SCI who underwent VUDS between 2011 and 2021. Participant characteristics, clinical data and indications for UDS and VUDS as well as bladder management were recorded. The added value of VUDS was defined as additional information not provided by standard UDS that impacted on bladder management (choice of voiding mode, surgical indication or type of surgery). Results Eighty‐eight men with a median age of 52 years were included. In 20 men who were unable to perform self‐catheterisation, the VUDS clarified the nature and extent of the obstruction and enabled targeted surgery to achieve reflex bladder emptying in all of them. VUDS also clarified the type and level of obstruction in 28 patients, enabling targeted surgery in 24. In 11 men, VUDS was performed as part of the preoperative assessment for a Brindley procedure or after this operation if a complication occurred during follow‐up to confirm the need for further surgery or to target surgical revision. Overall, VUDS had added value in 59 patients (67%). Conclusions VUDS had added value over UDS in specific situations; the additional information provided impacted on bladder management in men with SCI and NLUTD.