Investig Clin Urol.  2019 Sep;60(5):405-411. 10.4111/icu.2019.60.5.405.

Transvesicoscopic Politano-Leadbetter ureteral reimplantation in children with vesicoureteral reflux: A novel surgical technique

• Baek M
• Han DH

• KMID: 2455969
• DOI: http://doi.org/10.4111/icu.2019.60.5.405

Abstract

PURPOSE
We introduce our novel procedure for transvesicoscopic ureteral reimplantation using the Politano-Leadbetter technique (TVUR-PL). We describe the detailed surgical procedure and report operative outcomes.
MATERIALS AND METHODS
We report a retrospective analysis of operative outcomes of TVUR-PL performed in children with vesicoureteral reflux (VUR) from January 2017 to July 2018. The analyzed operative outcomes included patient demographics, operative times, intra- and postoperative complications, indwelling duration of urethral Foley catheter, hospital length of stay, and treatment success.
RESULTS
A total of 47 patients (17 males, 30 females) underwent TVUR-PL during the study period, including 18 unilateral and 29 bilateral cases (76 ureters). All operations were successfully completed without open conversion. The median operative time was 121 minutes for unilateral cases and 178 minutes for bilateral cases. The median duration of placement of a urethral Foley catheter was 2 days. There were no intra- or postoperative complications. Only one patient (1/47 patients, 2.1%), who had no postoperative VUR on voiding cystourethrography, experienced febrile urinary tract infection during the follow-up period.
CONCLUSIONS
Our novel TVUR-PL technique is a safe and effective minimally invasive surgical treatment option for children with VUR. The main advantage of our new operation is that it allows us to maintain the natural direction of the ureter after surgery.

Keyword

Child; Laparoscopy; Vesico-ureteral reflux

MeSH Terms

Catheters
Child*
Demography
Follow-Up Studies
Humans
Laparoscopy
Length of Stay
Male
Operative Time
Postoperative Complications
Replantation*
Retrospective Studies
Ureter*
Urinary Tract Infections
Vesico-Ureteral Reflux*

Figure

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  Fig. 1 Laparoscopic instruments used for operation.

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  Fig. 2 Operative time in relation to increasing case numbers.

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