Analysis of the efficacy and complications of laparoscopic Cohen's ureteral reimplantation in the treatment of pediatric vesicoureteral reflux

Abstract Purpose To analyze the efficacy of Cohen’s laparoscopic ureteral reimplantation in the treatment of pediatric vesicoureteral reflux and the associated common postoperative complications and their management. Materials and methods The clinical data of children with vesicoureteral reflux who underwent Cohen’s laparoscopic ureteral reimplantation at our hospital between January 2018 and December 2022 were retrospectively analyzed. Subsequently, the postoperative complications were managed and summarized. Results The average duration of Cohen's laparoscopic ureteral reimplantation surgery was 190.8 ± 52.9 min. The median blood loss was 10 mL. The inner diameter of ureter was 0.6 ± 0.3 cm, and the anterior-posterior diameter of the kidney pelvis was 0.9 ± 0.4 cm after surgery and exhibited significant reductions when compared to the pre-surgical measurements (1.1 ± 0.5 cm and 2.2 ± 1.2 cm, respectively). The thickness of the kidney cortex (0.56 ± 0.18 cm) displayed a significant increase relative to its preoperative measurement (0.45 ± 0.15 cm). The surgical intervention resulted in a substantial decrease in the occurrence of reflux in children, dropping from 100% preoperatively to 3.1% postoperatively. Similarly, the rate of urinary tract infection after surgery significantly decreased to 15.6%, compared to the preoperative percentage of 90.6%. seven children developed bladder spasm, five experienced postoperative hydronephrosis, and one had ureteral obstruction. Additionally, nine children experienced bladder dysfunction such as urinary frequency and urgency post-surgery. Conclusions Cohen’s laparoscopic ureteral reimplantation is an effective treatment for primary vesicoureteral reflux in children. Although it is not always possible to entirely prevent postoperative complications, active management can aid in their gradual recovery.