This study aims to assess the surgical outcomes of laparoscopic or robotic surgery for primary vesicoureteral reflux and elucidate the factors contributing to vesicoureteral reflux resolution.
We retrospectively reviewed the medical records of consecutive patients who underwent extravesical laparoscopic ureteral reimplantation or robot-assisted laparoscopic ureteral reimplantation at our institution between March 2012 and July 2020. First, we reviewed surgical outcomes in the paediatric (n = 100) and adult (n = 15) patient groups. Second, we compared the surgical findings and outcomes of both procedures in the paediatric patient group and investigated the factors contributing to surgical success in the paediatric patient group.
The combined success rates for both procedures were 89.1% in the paediatric group and 70.0% in the adult group. The overall success rate among paediatric patients was not significantly different between those who underwent laparoscopic ureteral reimplantation (91.1%) and those who underwent robot-assisted laparoscopic ureteral reimplantation (85.5%). Post-operative urinary retention was observed in 5.0% and 6.7% of paediatric and adult patients, respectively. Univariate and multivariate analyses revealed that the ureteral diameter measured during surgery was significantly associated with vesicoureteral reflux resolution regardless of the use of a robotic platform (p = 0.046).
Both laparoscopic and robot-assisted laparoscopic ureteral reimplantation are favourable and safe procedures for paediatric patients with primary vesicoureteral reflux. To improve the success rate, a sufficient length of the submucosal tunnel must be ensured based on intraoperative measurements of ureteral diameter.
BJUI compass. 2025 Jul 22*** epublish ***
Kentaro Mizuno, Hidenori Nishio, Daisuke Matsumoto, Takuya Sakata, Akihiro Nakane, Hideyuki Kamisawa, Satoshi Kurokawa, Tetsuji Maruyama, Keiichi Tozawa, Takahiro Yasui, Yutaro Hayashi
Department of Pediatric Urology Nagoya City University Graduate School of Medical Sciences Nagoya Japan., Department of Urology Nagoya City University West Medical Center Nagoya Japan., Department of Nephro-urology Nagoya City University Graduate School of Medical Sciences Nagoya Japan., Department of Urology Gamagori City Hospital Gamagori Japan., Department of Urology Anjo Kosei Hospital Anjo Japan., Department of Urology Nagoya City University East Medical Center Nagoya Japan., Department of Medical Safety Management Nagoya City University Graduate School of Medical Sciences Nagoya Japan.