Surgical success following robotic upper urinary tract reconstruction, results from a global network of healthcare organizations.

INTRODUCTION: Available data on robotic ureteral reconstruction procedures is concentrated from high volume centers. To better understand generalizability of success, we used a network of healthcare organizations (HCOs) to evaluate surgical success following robotic-assisted pyeloplasty (RP), ureteral reimplantation (RR), and ureteroureterostomy/ureteroplasty (RU). METHODS: We searched the TriNetX database for adult (>18 years old) patients undergoing RP, RR and RU. Our primary outcome was need for drain placement (nephrostomy or ureteral stent) from 4 weeks to 10 years postoperatively. We evaluated risk factors (RF) for drain placement (vascular disease, kidney disease, diabetes (DM), smoking history, radiation history, age, body mass index (BMI, kg/m^2)) using hazard ratios, with significance when 95% confidence interval does not include 1.0. RESULTS: Analyses were run in October 2024. There were 1,324 RP patients from 30 HCOs, 464 RR patients from 22 HCOs, and 875 RU patients from 27 HCOs. Respectively, 10.8%, 11.7%, and 7.9% of patients needed a drain. DM (HR 2.0 (1.04–3.68)), smoking (HR 2.2 (1.34–3.49)), and BMI > 25 (HR 1.6 (1.07–2.34)) were RFs for drain placement following RP. DM (HR 2.8 (1.18–6.63)) was also a RF for RR patients. Radiation was a RF for both RR (HR 2.9 (1.03–8.09)) and RU (HR 3.7 (1.006–13.9)) patients. Age > 50 years (HR 2.3 (1.16–4.49)) was a RF for RU patients. CONCLUSIONS: We report outcomes of robotic ureteral reconstruction from a variety of HCOs. This data helps describe the real world experience of patients undergoing robotic upper urinary tract reconstruction.