555 Robotic Mainz II pouch for failed exstrophy-epispadias complex

Dr. Sidhartha Kalra

Bladder exstrophy–epispadias complex is a rare anomaly, and failure of primary repair often leads to persistent urinary leakage and compromised quality of life. Continent urinary diversion with a Mainz II pouch provides an alternative for patients wishing to avoid stomas or lifelong catheterization. We report two cases—a 17-year-old male and a 30-year-old female—with failed exstrophy–epispadias repair who underwent robotic-assisted Mainz II diversion using a detubularized sigmoid segment, with ureteral implantation via an extramural tunnel. The male underwent penile reconstruction, while local flap closure was done in the female. At 3 months, both patients achieved continence, preserved renal function, and maintained sexual health. Robotic-assisted Mainz II pouch is a promising option for selected young patients, offering reliable continence, preservation of function, improved cosmesis, easier adhesiolysis and faster recovery. Urologic Surgery

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