Introduction: We present a unique case report of complete bladder prolapse through the urethra. We additionally demonstrate the surgical technique of robotic-assisted Burch Colposuspension and bladder neck reconstruction to address multiple urologic problems for a patient who was not a candidate for a mid-urethral sling, and who required concomitant pelvic organ prolapse repair. Methods: The patient’s initial presentation of bladder prolapse through the urethra was repaired with manual reduction, urethroplasty, bladder neck closure, and cystorrhaphy. Her subsequent Burch Colpopsuspension was performed robotically. The Da Vinci Xi robot was used with a 5-port configuration, including an assistant port. Surgical steps described in this video include dissection of vagina off bladder, apical uterosacral ligament suspension, dropping the bladder, bladder neck reconstruction, Burch Colposuspension, paravaginal repair, and new suprapubic tube placement. Results: A successful treatment of a freely mobile, prolapsing bladder and near absent urethra causing severe urinary incontinence is achieved. The patient remains continent and her bladder remains well reduced post-operatively. Conclusions: Robotic-assisted laparoscopic Burch Colposuspension represents a minimally-invasive, effective option for patients who present with multiple different urologic issues, including pelvic organ prolapse and stress urinary incontinence. SOURCE OF Funding: N/A
