Robotic Simple Cystectomy as a Last Resort for Antibiotic-Recalcitrant Recurrent Urinary Tract Infections in Women - Beyond the Abstract
In older patients with associated co-morbidities, like those in this series from a tertiary care center, we studied the perceived advantages of relying on a rather new robotic approach heralded by our oncology colleagues, rather than the traditional open laparotomy.
From the patient's perspective, robotic surgery has a strong appeal due to small incisions which usually heal fine, and a marked reduction in post-operative pain compared to a conventional open cystectomy. However, as pointed out by this series, the usual complications of urinary diversion still apply, and cannot be overlooked when offering this alternative therapy. These complications revolve around peri-operative infection risks, the patient's general health status, and prior abdominal procedures. Consultation with Infectious disease, along with anesthesiologists and internists, is mandatory before considering this last resort approach. An improvement in quality of life was noted in the majority of our patients. A multi-centric study will be needed to further delineate the optimal candidate for this procedure and capture long-term data.
Written by: Philippe E. Zimmern MD, FACS, URPS, Professor of Urology, Felecia and John Cain Distinguished Chair in Women’s Health, Director of the Marie and Bernard Zimmern Fund in Female Urology, Director of the John and Felecia Cain Center for Bladder Health, University of Texas Southwestern Medical Center, Dallas, Texas
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