Healing with precision - Robotic Mitrofanoff procedure with autologous pubovaginal sling in neurogenic incontinence
A 21-year-old obese female presented with urinary incontinence and lower limb weakness after a D11-L3 laminectomy for spinal teratoma. Evaluation revealed a patulous urethra with video-urodynamic study suggestive of hyposensory, hypocontractile bladder of 500 ml capacity with open bladder neck, intr...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2025-07-01
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| Series: | Indian Journal of Urology |
| Online Access: | https://journals.lww.com/10.4103/iju.iju_122_25 |
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| author | Sidhartha Kalra Siddhant Bolar Rajat Mudhol Shiva Gour |
| author_facet | Sidhartha Kalra Siddhant Bolar Rajat Mudhol Shiva Gour |
| author_sort | Sidhartha Kalra |
| collection | DOAJ |
| description | A 21-year-old obese female presented with urinary incontinence and lower limb weakness after a D11-L3 laminectomy for spinal teratoma. Evaluation revealed a patulous urethra with video-urodynamic study suggestive of hyposensory, hypocontractile bladder of 500 ml capacity with open bladder neck, intrinsic sphincter deficiency, and good compliance. Due to obesity, perineal hypoesthesia, and clean intermittent catheterization (CIC) challenges, a robotic Mitrofanoff channel and continent bladder neck (tensor fascia lata graft) were planned. Tension-free channel was achieved by removing one row of staples to increase channel length, use of indocyanine green intraoperatively to assess vascularity, and umbilicus as site of Mitrofanoff to avoid thick pannus. At 3-months’ follow-up, the patient performed CIC comfortably every 5 h and was continent. |
| format | Article |
| id | doaj-art-cb1a19ed562b453aa6beeeb5136c6dc8 |
| institution | DOAJ |
| issn | 0970-1591 1998-3824 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Indian Journal of Urology |
| spelling | doaj-art-cb1a19ed562b453aa6beeeb5136c6dc82025-08-20T02:56:30ZengWolters Kluwer Medknow PublicationsIndian Journal of Urology0970-15911998-38242025-07-0141323023110.4103/iju.iju_122_25Healing with precision - Robotic Mitrofanoff procedure with autologous pubovaginal sling in neurogenic incontinenceSidhartha KalraSiddhant BolarRajat MudholShiva GourA 21-year-old obese female presented with urinary incontinence and lower limb weakness after a D11-L3 laminectomy for spinal teratoma. Evaluation revealed a patulous urethra with video-urodynamic study suggestive of hyposensory, hypocontractile bladder of 500 ml capacity with open bladder neck, intrinsic sphincter deficiency, and good compliance. Due to obesity, perineal hypoesthesia, and clean intermittent catheterization (CIC) challenges, a robotic Mitrofanoff channel and continent bladder neck (tensor fascia lata graft) were planned. Tension-free channel was achieved by removing one row of staples to increase channel length, use of indocyanine green intraoperatively to assess vascularity, and umbilicus as site of Mitrofanoff to avoid thick pannus. At 3-months’ follow-up, the patient performed CIC comfortably every 5 h and was continent.https://journals.lww.com/10.4103/iju.iju_122_25 |
| spellingShingle | Sidhartha Kalra Siddhant Bolar Rajat Mudhol Shiva Gour Healing with precision - Robotic Mitrofanoff procedure with autologous pubovaginal sling in neurogenic incontinence Indian Journal of Urology |
| title | Healing with precision - Robotic Mitrofanoff procedure with autologous pubovaginal sling in neurogenic incontinence |
| title_full | Healing with precision - Robotic Mitrofanoff procedure with autologous pubovaginal sling in neurogenic incontinence |
| title_fullStr | Healing with precision - Robotic Mitrofanoff procedure with autologous pubovaginal sling in neurogenic incontinence |
| title_full_unstemmed | Healing with precision - Robotic Mitrofanoff procedure with autologous pubovaginal sling in neurogenic incontinence |
| title_short | Healing with precision - Robotic Mitrofanoff procedure with autologous pubovaginal sling in neurogenic incontinence |
| title_sort | healing with precision robotic mitrofanoff procedure with autologous pubovaginal sling in neurogenic incontinence |
| url | https://journals.lww.com/10.4103/iju.iju_122_25 |
| work_keys_str_mv | AT sidharthakalra healingwithprecisionroboticmitrofanoffprocedurewithautologouspubovaginalslinginneurogenicincontinence AT siddhantbolar healingwithprecisionroboticmitrofanoffprocedurewithautologouspubovaginalslinginneurogenicincontinence AT rajatmudhol healingwithprecisionroboticmitrofanoffprocedurewithautologouspubovaginalslinginneurogenicincontinence AT shivagour healingwithprecisionroboticmitrofanoffprocedurewithautologouspubovaginalslinginneurogenicincontinence |