Feasibility of Robotic Cystectomy for Patients with Neurogenic Lower Urinary Tract Dysfunction and Interstitial Cystitis

Recent research published in the July edition of BJUI Compass demonstrates that robot-assisted laparoscopic supratrigonal cystectomy combined with augmentation cystoplasty (RA-SC-AC) is a viable surgical approach for adults suffering from neurogenic lower urinary tract dysfunction (NLUTD) and interstitial cystitis/bladder pain syndrome (IC/BPS). This minimally invasive procedure shows promising long-term outcomes concerning bladder function and symptom relief.

A retrospective study conducted by Thomas Batard and colleagues from Nantes Université, France, analyzed medical records of 71 adult patients who underwent RA-SC-AC between 2012 and 2020. The cohort consisted of 41 patients with NLUTD and 30 with IC/BPS. The patients were monitored for a median period of approximately 4.8 years.

The study found that early postoperative complications occurred in approximately 37% of patients, primarily minor issues classified as Clavien grade 2 or below. There were three significant late complications: one bladder perforation and two bowel obstructions, which are considered more severe but relatively rare.

Most patients experienced positive surgical outcomes. About 90% of those with NLUTD attained a low-pressure reservoir, which helps protect kidney function. The continence rate improved markedly, rising from 48% before surgery to over 92% after. For individuals with IC/BPS, pain scores improved significantly from an average of 7.8 to 2.2, and bladder capacity increased from about 112 mL to 304 mL, providing substantial relief of symptoms.

Despite some patients requiring ongoing intermittent catheterization and experiencing surgical failures with persistent severe symptoms, the overall results support RA-SC-AC as an effective long-term solution. The authors emphasize that this approach offers durable benefits in bladder capacity, pain reduction, and continence, with acceptable risks.

Further studies, especially controlled and randomized trials, are recommended to better understand the specific advantages of robotic surgery and to refine patient selection criteria, particularly in complex cases. Two of the authors disclosed ties to the surgical device manufacturer, Intuitive Surgical.

This study highlights the growing role of robotic surgery in managing complex urological conditions, offering hope for improved quality of life for patients with challenging bladder disorders.

Source: https://medicalxpress.com/news/2025-07-robotic-cystectomy-approach-feasible-nlutd.html