Transvesicoscopic cross-trigonal ureteroneocystostomy in children: a single-center experience.

Purpose: To evaluate the safety and efficacy of transvesicoscopic ureteric reimplantation in children.

Patients And Methods: Seventeen ureteric units in 11 patients underwent a transvesicoscopic 'Cohen' ureteroneocystostomy in 2003-2007 and the results were retrospectively analyzed. There were four boys and seven girls. All patients had vesicoureteric reflux (VUR), except for one with paraostial diverticula. Six patients underwent bilateral and five unilateral transvesicoscopic reimplantation (a total of 17 units).

Results: The procedure was successfully completed in all patients. Mean operation time was 217 min in unilateral cases and 306 min in bilateral cases without perioperative complications, except for pneumoperitoneum development in two cases. In the early postoperative period, two patients developed macroscopic hematuria. Mean hospital stay was 3.8 days (3-5 days), except for one patient who suffered from urinary tract infection and needed longer hospitalization. Mean follow-up period was 4.5 years (3-7 years). One patient with bilateral VUR had passive unilateral grade I VUR on postoperative cystogram, giving a success rate of 91% (94% of ureters). This patient was followed conservatively. One patient had recurrent urinary tract infections without reflux.

Conclusion: Transvesicoscopic cross-trigonal ureteroneocystostomy can be safely performed with a high success rate in children.