Modified robot-assisted laparoscopic Young-Dees-Leadbetter (mYDL) bladder neck reconstruction (BNR) combined with modified Cantwell-Ransley technique provides a promising approach to combine robot-assisted and open techniques for one-stage repair of epispadias.

A 13-year-old male patient presented with isolated epispadias, and persistent urinary incontinence. Preoperative urinalysis revealed hematuria. The patient was positioned in lithotomy with a steep Trendelenburg angle. Ports were placed for optimal robotic access. The bladder was mobilized, and a midline incision was made. Two traction sutures were used to maximize exposure of the bladder neck. The neourethral mucosa was marked, and ureteral reimplantation was deemed unnecessary. A suprapubic catheter was placed. Bladder neck reconstruction was performed, and its integrity was confirmed. The patient was then repositioned supine. An incision was made along the coronal sulcus and around the urethral plate. The ventral foreskin was degloved, and dorsal folding was performed. Parallel incisions on the urethral plate created glans wings for reconstruction.

The total operative time was 6 hours, with an estimated blood loss of 50 mL. The patient regained bowel function on postoperative day 1 and was discharged on day 7. At the one-month follow-up, the patient was able to hold urine for 4 hours with no evidence of reflux, urinary retention, or hydronephrosis.

This combined surgical approach effectively addresses bladder neck and urethral reconstruction in a single stage. This is the first reported one-stage epispadias reconstruction in China, offering a novel strategy for epispadias.