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.

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.

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.

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.

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