Long-term Outcomes of Cohen's Reimplantation in 182 Patients with Vesicoureteral Reflux

Park, Jong Min; Kim, Jin Il; Jeon, Seung Hyun

Abstract

PURPOSE: The perioperative and long-term outcomes of patients with vesicoureteral reflux (VUR) treated by cross-trigonal ureteroneocystostomy (Cohen's reimplantaion) over the last 18 years were ascertained.
MATERIALS AND METHODS
182 patients (322 renal units), who underwent Cohen's reimplantaion between January 1987 and February 2004, were retrospectively examined. The VUR grades were III in 38, IV in 214 and V in 70 renal units. The patients were followed up with postoperative voiding cystourethrography and intravenous pyelography for a mean 54.3, ranging from 3 to 176 months.
RESULTS
The operation was successful in 316 of the 322 renal units (98.1%). The correction rates, according to the reflux grade, were 100, 98.6 and 95.7% for grades III to V, respectively. The correction rates, according to the period, were 98 and 98.4% before and after 1995, respectively. The correction rates, according to age, were 98.1 and 98.2% for below and above 2-years-old, respectively. The mean hospital stay was 8.4 days (6-21). Postoperative complications were observed in 11 patients, including persistent pyuria, persistent ipsilateral reflux, new contralateral reflux, paralytic ileus and acute pyelonephritis. Only 1 of these 11 patient required re-operation, while the remaining 10 were resolved during further follow up.
CONCLUSIONS
A Cohen's reimplantation offers very good long-term results in curing VUR. This technique is a safe and effective method for ureteral reimplantation in patient with VUR, as it shows a relatively high success and low complication rates.