LAUSR

bladder neck is located and the ventral part of the prostate is exposed. An anterior longitudinal incision is performed starting from the bladder neck over the ventral vesico-prostatic junction down through the stenotic area to the external sphincter. The incision is enlarged to an inverted Y-shaped opening and an indwelling catheter is inserted. The tip of the V-shaped bladder flap is brought to the base of the inverted Y and closed with a running barbed suture. RESULTS: 22 patients with BNS underwent RAYV (table 1). All patients had undergone at least 2 transurethral procedures for the initial treatment. No conversion to open surgery had to be performed. The median operative time (skin to skin) was 133 min (range 69-180), the estimated blood loss was median of 5 (range 0-200) ml. There were no intraoperative and four patients with Clavien Dindo III as postoperative complications. The transurethral indwelling catheter was removed after 8 (4-25) days. The hospitalization period was median 5 (3-14) days, as patients preferred to leave the hospital without an indwelling catheter. Most of the patients showed six weeks postoperative a significant improvement of dysuria and residual volume as well as an increasing uroflowmetry (table 2). There was no recurrence of BNS with a median follow-up of 19.4 (2-42) months. CONCLUSIONS: The extraperitoneal robotic YV-plasty is a feasible and minimally invasive approach for recurrent bladder neck stenosis. Still, long-term results must confirm the efficacy in the future.