Purpose: Robot-assisted radical cystectomy (RARC) provides oncologic safety with potential for improved functional outcomes. However, urinary continence and sexual function remain underreported, especially in female patients. Surgical
Surgical Methods: This video presents surgical techniques for improving functional recovery after RARC with intracorporeal neobladder. In male patients, athermal retrograde nerve-sparing using 30° lens toggling, minimal apical dissection, and layered posterior reconstruction supported early continence and erectile function. In female patients, lateral-to-medial nerve preservation, endopelvic fascia sparing, round ligament suspension, and transverse vaginal cuff closure helped maintain continence and sexual function.
Results: The application of these tailored, sex-specific techniques was associated with favorable early functional outcomes, including urinary continence and sexual function recovery.
Conclusions: These tailored, sex-specific strategies demonstrate that meticulous techniques can improve quality of life in bladder cancer survivors.