Comparison of efficacy and safety between robotic-assisted and open surgery in treating neurogenic bladder: a systematic review and meta-analysis of comparative studies.

The safety and effectiveness of robotic-assisted surgery versus traditional open surgery for neurogenic bladder treatment remains uncertain, with no definitive conclusion drawn. This systematic review and meta-analysis aims to evaluate the differences between the two methods, offering additional insights to inform clinical decision-making. A detailed analysis of existing literature was carried out, referencing key databases such as EMBASE, Cochrane Library, Web of Science, PubMed, and Google Scholar, with data collection extending to February 2025. Statistical analysis was performed using Stata 18. For continuous variables, the weighted mean difference (WMD) was calculated, while the odds ratio (OR) was used to assess categorical variables. Confidence intervals (CIs) at the 95% level were included for all results. To evaluate the robustness of the findings, sensitivity analyses were conducted. In addition, Begg's test was employed to assess the potential for publication bias. This meta-analysis included data from ten comparative studies, involving 505 patients. Compared to those undergoing open surgery, patients who received robotic-assisted surgery had shorter hospital stays (OR = 0.57, 95% CI 0.34, 0.97; P = 0.038), a trend toward reduced blood transfusion volumes (WMD = - 446.72, 95% CI - 762.5, - 130.95; P = 0.006), lower blood transfusion rates (OR = 0.25, 95% CI 0.08, 0.82; P = 0.02), and lower reoperation rates(WMD = - 3.44, 95% CI - 5.68, - 1.2; P = 0.03). Robotic-assisted surgery for neurogenic bladder appears to offer potential advantages, including reduced hospital stay, lower blood transfusion requirements, and decreased likelihood of reoperation. Further validation of these findings requires the conduction of prospective, multicenter studies.