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Background and Objectives:To compare open versus totally intracorporeal robotic-assisted radical cystectomy, bilateral extended pelvic lymph node dissection, and Studer urinary diversion in bladder cancer patients.Methods:A retrospective comparison of open (n = 42) versus totally intracorporeal (n = 32) robotic-assisted radical cystectomy, bilateral extended pelvic lymph node dissection, and Studer urinary diversion was performed concerning patient demographic data, operative and postoperative parameters, pathologic parameters, complications, and functional outcomes.Results:Patient demographic data and the percentages of patients with pT2 disease or lower and pT3–pT4 disease were similar between groups (P > .05). Positive surgical margin rates were similar between the open (n = 1, 2.4%) and robotic (n = 2, 6.3%) groups (P > .05). Minor and major complication rates were similar between groups (P > .05). Mean estimated blood loss was significantly lower in the robotic group (412.5 ± 208.3 mL vs 1314.3 ± 987.1 mL, P < .001). Significantly higher percentages of patients were detected in the robotic group regarding bilateral neurovascular bundle–sparing surgery (93.7% vs 64.3%, P = .004) and bilateral extended pelvic lymph node dissection (100% vs 71.4%, P = .001). The mean lymph node yield was significantly higher in the robotic group (25.4 ± 9.7 vs 17.2 ± 13.5, P = .005). The number of postoperative readmissions for minor complications was significantly lower in the robotic group (0 vs 7, P = .017). Better trends were detected in the robotic group concerning daytime continence with no pad use (84.6% vs 75%, P > .05) and severe daytime incontinence (8.3% vs 16.6%, P > .05). No significant differences were detected regarding postoperative mean International Index of Erectile Function scores between groups (P > .05).Conclusions:Robotic surgery has the advantages of decreased blood loss, better preservation of neurovascular bundles, an increased lymph node yield, a decreased rate of hospital readmissions for minor complications, and a better trend for improved daytime continence when compared with the open approach.

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To evaluate the effect of the Hounsfield unit (HU) value, calculated with the aid of non-contrast computed tomography, on the outcome of percutaneous nephrolithotomy (PCNL). Data for 83 patients evaluated in our clinic between November 2011 and February 2014 that had similar stone sizes, localizations, and radio opacities were retrospectively reviewed. The patients were grouped according to their HU value, in a low HU group (HU ≤ 1000) or a high HU group (HU > 1000). The two groups were compared based on their PCNL success rates, complications, duration of surgery, duration of fluoroscopy, and decrease in the hematocrit. There were no significant differences in terms of mean age, female-male ratio, or mean body mass index between the two groups (p > 0.05). The stone size and stone surface area did not differ significantly between the groups (p = 0.820 and p = 0.394, respectively). The unsuccessful PCNL rate and the prevalence of complications did not differ significantly between the two groups (p > 0.05). The duration of surgery, duration of fluoroscopy, and decrease in the hematocrit were significantly greater in the high HU group compared to the low HU group (p < 0.001). Calculating the HU value using this imaging method may predict cases with longer surgery durations, longer fluoroscopy durations, and greater decreases in hematocrite levels, but this value is not related to the success rate of PCNL.