Initial results with the Cohen cross-trigonal ureteroneocystotomy

Area of Science:

• Pediatric Urology
• Surgical Techniques
• Reflux Management

Background:

• Vesicoureteral reflux (VUR) affects numerous children, necessitating effective management strategies.
• Conservative management and surgical intervention are primary treatment options for pediatric VUR.
• The Cohen cross-trigonal ureteroneocystotomy is a recognized surgical approach for VUR.

Purpose of the Study:

• To evaluate the safety and efficacy of the Cohen cross-trigonal ureteroneocystotomy for pediatric VUR.
• To assess the outcomes of this surgical technique in a cohort of children with refluxing ureters.

Main Methods:

• Retrospective review of 109 children (157 ureters) with VUR treated between 1976 and 1980.
• Surgical group: 52 ureters treated with Cohen cross-trigonal ureteroneocystotomy.
• Conservative group: 105 ureters managed non-operatively.
• Follow-up included excretory urography and voiding cystourethrography.

Main Results:

• The Cohen cross-trigonal ureteroneocystotomy group showed minimal hydronephrosis in only 1 ureter.
• Persistent grade I reflux was observed in 1 ureter post-operatively.
• Conservative management outcomes were not detailed in comparison but implied less favorable results.

Conclusions:

• The Cohen cross-trigonal ureteroneocystotomy is a safe and effective antireflux procedure for pediatric VUR.
• This technique demonstrates a low rate of complications and persistent reflux.
• Initial results support the Cohen technique as a viable surgical option for managing pediatric VUR.