Robotic-assisted bladder neck procedures in children with neurogenic bladder



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.

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Fig. 1





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


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Author information




PCG: protocol/project development, data analysis, and manuscript editing. LAW: data collection, data analysis, and manuscript writing/editing.

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Correspondence to Lindsay A. White.

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Gargollo, P.C., White, L.A. Robotic-assisted bladder neck procedures in children with neurogenic bladder. World J Urol 38, 1855–1864 (2020).

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  • Neurogenic bladder
  • Robotic-assisted surgery
  • Bladder neck reconstruction
  • Artificial urinary sphincter
  • Bladder neck sling
  • Bladder neck closure