Pneumovesicoscopic Ureteral Reimplantation for Pediatric Vesicoureteral Reflux: Politano-Leadbetter versus Cohen Technique

Purpose To investigate and compare the clinical efficacy of pneumovesicoscopic Politano-Leadbetter and Cohen techniques in the treatment of primary vesicoureteral reflux (VUR) in children. Methods A retrospective analysis was conducted on 162 children with primary VUR (grades III-V) who underwent pneumovesicoscopic ureteral reimplantation. Patients were divided into Politano-Leadbetter group (Group P, n = 88) and Cohen group (Group C, n = 74), including 107 unilateral and 55 bilateral cases. Operative parameters and complications over a 6–30 months follow-up were compared. Results All procedures were completed successfully without conversion to open surgery. For unilateral reflux, there were no significant differences between Group P and Group C in terms of operative time (118.62 ± 28.97 vs. 114.34 ± 21.13 min, p  = 0.405), estimated blood loss (6.09 ± 0.97 vs. 5.95 ± 0.88 ml, p  = 0.438), duration of urethral catheterization (4.26 ± 0.57 vs. 4.44 ± 0.84 days, p  = 0.187), hospitalization (6.29 ± 1.69 vs. 6.37 ± 0.92 days, p  = 0.798), and incidence of complications (6.6% vs. 13.0%, p  = 0.236). Similarly, no significant differences in these parameters were observed in patients with bilateral reflux (all p  > 0.05). The overall success rate exceeded 98% in both groups. Conclusion Pneumovesicoscopic ureteral reimplantation is a safe and effective minimally invasive approach for pediatric VUR. Although the Politano-Leadbetter technique is more technically complex, it provides a more physiological ureteral path. Long-term outcomes require further validation.