Introduction: Vesicourethral anastomotic stenosis (VUAS) that is unresponsive to endoscopic treatment after radical prostatectomy can be treated with open or robot-assisted reconstruction. In this study, we aimed to compare the patency and complications of these two methods. Methods: Eighteen patients who underwent open perineal reconstruction surgery and ten patients who underwent robot-assisted (Da Vinci XI) transabdominal reconstruction surgery for VUAS between July 2017 and August 2022 were included in this study. Demographic, operative, and postoperative patient data were examined. The two methods were compared in terms of patency, complications, recurrence, and incontinence. Patency was defined as either the passage of a 16 French cystoscope or a maximum flow on uroflowmetry of >15 ml/s. Incontinence was defined as use of more than one pad per day. Results: The median age was 67 years, and the number of previous endoscopic interventions was seven in both groups. The median operation time was 120 and 150 minutes (p:0.175), median bleeding amount was 200 and 100 ml (p:0,001), and median hospitalization time was four and three days (0,001) in the open and robotic-asisted groups, respectively. Wound infection (Clavien grade 2) developed in one patient and puborectal fistula (Clavien grade 3b) developed in one patient in the open group. Wound infection (Clavien grade 2) developed in one patient and ileus (Clavien grade 2) developed in one patient in the robotic-asisted group (p:0,724). Patency rate is 77.8% and 80.0% (p:0,944) in the open and robotic-asisted groups, respectively. All patients (%100) in the open group experienced incontinence during the follow-up period. Of the six patients without pre-existing incontinence, five (16,6%) remained continent at the last follow-up in the robotic-asisted groups. Conclusions: Compared to open perineal reconstruction, robot-assisted transabdominal VUAS reconstruction has less bleeding and a shorter hospitalization time. Although the patency and complication rates of both methods are similar, robot-assisted reconstruction is superior in terms of continence rates. SOURCE OF Funding: There is no source of fundings.
