Abstract

Objective: Operative and nonoperative treatment options are available in the treatment of vesicoureteral reflux (VUR). In our study, the results of treatment, complications and postoperative follow-up findings of the patients who underwent antireflux surgery with Politano Leadbetter method were retrospectively examined and discussed with review of the literature.

Material and Method: Sixty-three cases of VUR who had been operated between 2005 and 2011 by the Politano Leadbetter method in our clinic were analyzed retrospectively. In our series open surgical intervention was applied as the first choice in the cases with grade 5 reflux over one year old and in patients with renal scarring detected on scintigraphic examinations. Open surgery was also performed in the cases of failed subureteric injection and in patients with recurrent episodes of urinary tract infections.

Results: The age of 63 patients (M:30, F:33) ranged between 4 months to 13 years (Mean: 4.23±3.45 years). Open surgery was the first choice in 42 patients (67 %), and 21 patients (33 %) underwent open surgery because of failed subureteric injection. In 63 patients, Grade 2 (n=1), 3 (n=9; 10 %), and 4 (n=35; 34 %) reflux in one, grade 3 reflux in nine (10 %), grade 4 reflux in 35 (34 %), grade 5 (n=47; 55 %)refluxes were detected. a total of 92 ureters were reimplanted, and 89.2 % of the ureters completely recovered after the surgery.

Conclusion: In children with VUR, Politano Leadbetter operation can be applied safely with a low complication rate. If the surgical intervention could be done extraperitoneally, the potential complications may be reduced. Adhesive intestinal obstruction can be seen as a complication in cases of peritoneal perforation or bowel injury.