Transvesicoscopic approaches for ureteral reimplantation (UR) are effective surgical
techniques with which to resolve vesicoureteral reflux (VUR) or primary obstructive
megaureter (POM) in pediatric patients. However, the effectiveness of different UR
surgical methods for these two diseases is still unclear.
To compare the effects of Cohen's cross-trigonal and Politano-Leadbetter techniques
in children in need of UR.
A retrospective chart review was performed for consecutive patients who underwent
UR at our institution between May 2018 and November 2019, including those treated
for vesicoureteral reflux (VUR) or primary obstructive megaureter (POM). Patients
who underwent Cohen's technique included in Group C, and those who underwent the Politano-Leadbetter
technique were included in Group P. Patient characteristics, perioperative parameters,
and short-term postoperative outcomes were compared.
Forty-six patients who underwent unilateral UR were included in the analysis. At presentation,
those in Group P (N = 22, 12 diagnosed with VUR and 10 with POM) did not differ from
those in Group C (N = 24, 12 diagnosed with VUR and 12 with POM) with respect to age,
sex, disease type or severity. For VUR patients, reflux was clinically resolved for
all patients in both groups; however, only a 75% resolution rate was observed in Group
C, with 3 patients experiencing persistent low-grade, clinically insignificant reflux,
while a 100% resolution rate was found in Group P (P > 0.05). Among POM patients,
the obstruction was resolved for all those in Group P and for 90% of those in Group
C; this difference was also not statistically significant (P > 0.05). At the 1-year
follow-up, the ureteral diameter (P < 0.05) and anterior-posterior renal pelvic diameter (APRPD) (P < 0.05) of Group P were significantly reduced, and differential renal function (DRF)
(P < 0.05) was slightly improved compared with that in Group C in both VUR and POM patients.
Politano-Leadbetter and Cohen are both reliable techniques for UR in children with
VUR or POM, and the short-term outcomes of these methods in solving reflux and obstruction
are comparable. Besides traditional Cohen's technique, Politano-Leadbetter's technique
maybe a potential choice for ureteral reimplantation in children.