Transvesicoscopic ureteral reimplantation: Politano–Leadbetter versus Cohen technique

Abstract

Objectives: To compare the outcomes of the Politano-Leadbetter and Cohen techniques in laparoscopic pneumovesicum approach for ureteral reimplantation. Methods: We retrospectively reviewed the medical records of 24 patients who underwent transvesicoscopic ureteral reimplantation during the period from 2007 to 2014. The patients were treated with either the Cohen or Politano-Leadbetter technique. Operative duration, duration of hospital stay, and success and complication rates were compared. Results: Operative duration was 1 h longer for the Politano-Leadbetter technique than for the Cohen technique (P < 0.05). Foley catheters were removed 2-3 days after the procedures. The mean hospital stay was 3.6 days. Reflux completely resolved in 21 patients (35 ureters, 94.6%), but not in two patients (2 ureters). There was no difference in the success rate or durations of catheterization or hospital stay between patients treated with the Politano-Leadbetter technique and those treated with the Cohen technique. Conclusions: The Politano-Leadbetter and Cohen techniques are both reliable for transvesicoscopic ureteral reimplantation. Despite a longer operative time, because of the higher surgical complexity, the Politano-Leadbetter ureteral reimplantation offers important physiological advantages over other techniques.

Guidelines for the medical management of pediatric vesicoureteral reflux

“…The incidence of anastomotic stricture was shown to be similar between laparoscopic surgery and open surgery . The Politano–Leadbetter technique has a success rate of 94.4%, and is recommended for treatment in women with high‐grade VUR requiring the creation of a long submucosal tunnel, although with a longer operation time than Cohen’s technique …”

Lessons learned over a decade of pediatric robotic ureteral reimplantation

“…A notable point is that, despite the similar time of introduction of intravesical RALUR in the literature with conventional laparoscopic intravesical ureteral reimplantation [33], no other reports on intravesical RALUR have been published in the literature beyond the initial articles unlike the increasing number of articles of further procedural development with conventional laparoscopic intravesical ureteral reimplantation [34353637383940]. Technical challenges with laparoscopic reimplantation and the expansion of the number of robotic systems worldwide may partially explain this evolution toward robotic reimplantation, as well as the multijointed angulation provided by the robotic instruments that facilitates the ureteral mobilization, submucosal tunneling, and suturing.…”

Minimally invasive surgery in the management of vesicoureteral reflux

“…Soh ve ark. (20) aynı yıl yaptıkları çalışmada, transvezikoskopik PL ile Cohen tekniklerinin sonuçları kıyaslanmıştır. Deneyimler sınırlı olmakla birlikte, PL tekniğinde cerrahi süre daha uzun bulunmuş ancak başarı oranları ve kıyaslanan diğer yönleri ile benzer sonuçlar bildirilmiştir.…”