Bladder neck: anatomic variants, Prior TUR, locally advanced tumours

Although there are many steps during robotic-assisted radical prostatectomy (RARP) in which variant anatomy can provide difficulties in surgical dissection, it is during bladder neck dissection that such variants can prove to be most challenging. In particular, dissection of the posterior bladder neck, which is already a difficult step for those in the early part of their learning curve, can provide extra challenges in patients with anatomical variants such as: Median lobe Previous bladder outlet surgery Large prostate size Locally advanced tumour. In this chapter, we discuss these challenges and provide some advice for how to deal with such situations.