Transvesicoscopic Cohen Ureteric Reimplantation for Vesico-Ureteral Reflux in Children
The surgical correction of vesico-ureteral reflux (VUR) is the most frequent operation on the upper urinary tract in children. Several classical surgical techniques (e.g., Leadbetter-Politano, Lich-Gregoir, Cohen) have been widely proven on long-term follow up to correct pathological VUR. The main criteria for selecting a technique has been the success rate. In this respect, Cohen’s technique is probably the best, with resolution of reflux in approximately 98% of cases. However, bladder irritation and hematuria are the usual morbidities associated with bladder incision. The concept of minimally invasive management first appeared in 1984, with endoscopic correction by submucosal injection, an almost painless ambulatory method but one that is less effective than surgery (failure rate, 10% to 30%). Because of this competition between classical surgery and purely cystoscopic management, pediatric urologists loyal to the classical method have multiplied their efforts to simplify surgical techniques and to reduce postoperative pain and hospitalization.
KeywordsBladder Wall Pediatric Urologist Submucosal Injection Ureteral Reimplantation Duplex System
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