Transvesical Laparoscopic Cross-Trigonal Ureteral Reimplantation for Correction of Vesicoureteral Reflux: Initial Experience and Comparisons Between Adult and Pediatric Cases

Transvesical laparoscopic cross-trigonal ureteral reimplantation (TLCUR) has been reported as an alternative procedure for vesicoureteral reflux mainly in pediatric cases. We review our initial experience with TLCUR and evaluate its feasibility in adult patients. We performed TLCUR in 30 patients (22 females and 24 bilateral cases) with a median age of 14.5 years. The median operating time was 145 minutes in the unilateral cases and 230 minutes in the bilateral cases. Blood loss was minimal in all cases. No intraoperative complications were observed. The urethral catheter was removed at day 2 to 3. One persistence of reflux and one uretero-vesico anastomosis stricture were observed. The total success rate of 49 ureters in 27 patients, in whom postoperative cystography was performed, was 96% (47/49). Comparing the first 15 and last 15 cases, patient age was similar, the operation time was significantly shorter in the last 15 cases, and both operative failures were found in the first 15 cases. Comparing the 15 pediatric and 15 adult cases, the operation time did not differ between the two groups and one operative failure was observed in each group. This procedure was an effective and safe alternative minimally invasive procedure for both adult and pediatric patients with reflux.