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Pneumovesicoscopic correction of primary vesicoureteral reflux (VUR) in children. Our experience

A Marte1, M D Sabatino, M Borrelli

  • 1Second University of Naples, Pediatric Surgery, Naples, Italy. antonio.marte@unina2.it

European Journal of Pediatric Surgery : Official Journal of Austrian Association of Pediatric Surgery ... [Et Al] = Zeitschrift Fur Kinderchirurgie
|October 19, 2010
PubMed

Insights

Pneumovesicoscopic cross-trigonal ureteral reimplantation is a safe and effective minimally invasive technique for treating primary vesicoureteral reflux (VUR) in children. This procedure successfully resolved VUR in 13 of 14 pediatric patients.

Area of Science:

  • Pediatric Urology
  • Minimally Invasive Surgery
  • Urologic Oncology

Background:

  • Primary vesicoureteral reflux (VUR) is a common congenital anomaly in children.
  • Surgical intervention is indicated for persistent or high-grade VUR to prevent renal scarring and damage.
  • Traditional open reimplantation can be associated with significant morbidity.

Purpose of the Study:

  • To evaluate the safety and efficacy of pneumovesicoscopic cross-trigonal ureteral reimplantation for primary VUR in children.
  • To assess the outcomes and complication rates of this minimally invasive approach.

Main Methods:

  • A cohort of 14 children (aged 4-12 years) with VUR grade III or higher underwent pneumovesicoscopic Cohen's cross-trigonal reimplantation.
  • The procedure involved cystoscopic guidance, trocar insertion, ureteral mobilization, submucosal tunnel creation, and ureteroneocystomy with absorbable sutures.
  • Postoperative follow-up included renal ultrasound, voiding cystourethrogram, and MAG3 scans.

Main Results:

  • The study included 14 children with 19 refluxing ureters.
  • Reflux resolution was achieved in 13 out of 14 patients (93%) within 3-6 months postoperatively.
  • The mean operating time was 136 minutes, with no conversions to open surgery required. Mild suprapubic emphysema occurred in one patient.

Conclusions:

  • Pneumovesicoscopic cross-trigonal ureteral reimplantation is a safe and effective minimally invasive surgical option for pediatric VUR.
  • This technique offers successful VUR correction with low complication rates.
  • Further studies may explore long-term outcomes and comparisons with other minimally invasive methods.
Abstract

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