Jonathan Yu, MD, on early repair of vesicourethral anastomotic leak

In the following video, Jonathan Yu, MD, discusses a study on early repair of vesicourethral anastomotic leak, which was presented at the 2026 Desai Sethi Urology Institute Urology on the Beach meeting in Miami Florida. Yu is a urology fellow at Thomas Jefferson University in Philadelphia, Pennsylvania.

Yu explained that traditional management of leaks is typically conservative, focusing on urinary diversion, such as prolonged catheterization, nephrostomy tube placement, or intra-abdominal drains, to allow the leak to resolve without surgical intervention. In contrast, the team has adopted an early repair approach using the da Vinci Surgical System. The procedure leverages prior robotic port sites, incorporates a cystotomy, and uses an intravesical approach to directly visualize and repair the defect, which Yu described as technically straightforward once the site of leakage is clearly identified.

Reviewing outcomes from their 11-patient series, Yu reported a median postoperative catheter duration of approximately 10 days, which he says is comparable to typical catheterization time following radical prostatectomy. The early repair strategy demonstrated a high success rate, although he emphasized the limitations of the small sample size and acknowledged that some failures did occur. Functional outcomes were favorable, with most patients reporting excellent continence and generally requiring no pads per day, with only a few using 1 pad daily.

Importantly, Yu noted the absence of intraoperative complications and no reported complications within the first postoperative month.