Robotic-Assisted Appendicovesicostomy and Fascia Lata Pubovaginal Sling Placement to Treat Neurogenic Bladder and Refractory Stress Urinary Incontinence

Mason M1, Carino Mason M1, Syan R2

Research Type

Clinical

Abstract Category

Female Lower Urinary Tract Symptoms (LUTS) / Voiding Dysfunction

Abstract 595
Robotic Bladder Neck, Artificial Urinary Sphincter, Reconstructive, Pediatric and Tapes
Scientific Podium Video Session 36
Saturday 10th September 2022
15:32 - 15:41
Hall K2
Surgery Spinal Cord Injury Female Voiding Dysfunction
1. University of Miami Miller School of Medicine, 2. Desai Sethi Urology Institute, University of Miami Miller School of Medicine
Online
Presenter
Links

Abstract

Introduction
Robotic-assisted appendicovesicostomy is a frequently performed procedure in pediatric patients with congenital urinary tract abnormalities but has not been well described in adult patients for benign indications. This video demonstrates a stepwise approach to robotic-assisted appendicovesicostomy in a female with neurogenic bladder and bothersome stress urinary incontinence.
Design
We describe a case of a 48-year-old G0 female with neurogenic bladder and urinary incontinence following spinal cord injury in 1991 requiring chronic intermittent catheterization. Patient had significant high volume stress urinary incontinence (SUI) and previously failed a rectus fascial autologous pubovaginal sling placement. Urodynamics demonstrated atonic bladder with good capacity. Options were discussed with the patient, and she elected for a robotic-assisted appendicovesicostomy and fascia lata pubovaginal sling placement, with the possibility of bladder neck closure in the future, if SUI was persistent.
Results
The patient tolerated the procedure well, had an uncomplicated hospital course, and was discharged on post-operative day #3. At three weeks following the procedure, the patient was taught to catheterize her umbilical stoma. The patient was able to catheterize without issue and had resolution of her stress urinary incontinence six weeks after the procedure.
Conclusion
This video abstract demonstrates successful robotic-assisted laparoscopic placement of an appendicovesicostomy with fascia lata pubovaginal sling placement in a patient with neurogenic bladder and stress urinary incontinence requiring chronic intermittent catheterization.
Disclosures
Funding None Clinical Trial No Subjects Human Ethics not Req'd Surgical video Helsinki Yes Informed Consent Yes
Citation

Continence 2S2 (2022) 100484
DOI: 10.1016/j.cont.2022.100484

20/11/2024 15:53:58