Transvesicoscopic Politano-Leadbetter Ureteral Reimplantation In Children With Vesicoureteral Reflux: A Novel Surgical Technique

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.