Citation
Bourillon A, Freton L, Verhoest G, Hascoet J, Richard C, Haudebert C, Mathieu R, Zhao LC, Bensalah K, Peyronnet B. Robotic vs. open ureteral reimplantation: A retrospective comparative single-centre series. BJUI compass. 2025
Abstract
To compare the outcomes of open versus robotic ureteral reimplantation procedures at a single centre. The charts of all patients with ureteral strictures who underwent open ureteral reimplantation between 2005 and 2024, and those who underwent robotic reimplantation between 2013 and 2024, were retrospectively reviewed, and the outcomes of the two approaches were compared. Eighty patients were included in the final analysis: 45 in the open surgery group and 35 in the robotic group. After a median follow-up duration of 16,5 months for the open group and 10 months for the robotic group, the stricture recurrence rate was similar in both groups (6,8% vs. 8.6%; p = 0.99). In terms of long-term complications, there were similar rates of symptomatic reflux (4.4% vs. 5.7%; p = 0.99) and flank pain (8.9% vs. 8.6%; p = 0.99) between both groups. There were more recurrent urinary tract infections in the open group (17.8% vs. 8.6%) and more de novo lower urinary tract symptoms in the robotic group (11.4% vs. 2.2%), but these differences were not statistically significant (p = 0.33 and p = 0.16, respectively). Overall, 30 patients (38%) had at least one long-term complication (35.6% vs 40%; p = 0.82). The only variable significantly associated with the risk of stricture recurrence was radiotherapy (OR = 11.2; p = 0.01). The robotic approach appears to be non-inferior to the open approach in terms of stricture recurrence while being associated with a shorter length of hospital stay and lower estimated blood loss. More importantly, the present series raises questions regarding the long-term consequences of ureteral reimplantation and confirms the higher risk of failure in radiated patients.
Key Points
- Published in BJUI compass in 2025.
- Indexed in PubMed as PMID 41250765.
- Mapped to Ureteral Reconstruction, Urethral Stricture & Urethroplasty, Robotic & Single-Port.
- Abstract available from PubMed and rendered as static text on this page.
Clinical Relevance
This work sits within Dr. Zhao's upper urinary tract reconstruction bibliography, including robotic ureteral repair, buccal mucosa graft ureteroplasty, reimplantation, pyeloplasty failure, and complex salvage reconstruction.