**3. Surgical indications for cystectomy**

The rationale of performing a cystectomy for malignancy is the outcome and implications of such minimally invasive surgery where continence, potency and sexual function, plus enhanced recovery programs, play a better role. Nowadays, the robotic technique has been further developed by several groups, with more technical variations and anatomical findings, having the sparing of structures as part of the actual benefits. The lymphadenectomy plays also a very important role and their oncological results are quite strong. The **Figure 1** below shows an algorithm of disease management [17, 18].

#### **3.1 Immediate RC to patients with non-muscle-invasive tumors**


**Figure 1.** *Disease management algorithm.*

Subgroup of highest-risk tumors:


pTa: for refractory, relapsing or intolerance to BCG treatment.

pT1: multifocality, lamina propia invasion, recurrence after intravesical therapy, CIS.
