Objective:

To investigate and compare the clinical efficacy of pneumovesicoscopic Politano–Leadbetter and Cohen ureteral reimplantation for primary vesicoureteral reflux (VUR) in children.

Approach:

• Study Design: Retrospective review of 179 children with primary VUR who underwent pneumovesicoscopic ureteral reimplantation between October 2021 and January 2024.
• Patient Groups: Patients were divided into two groups: Politano–Leadbetter (Group P, n = 97) and Cohen (Group C, n = 82).
• Follow-Up: Postoperative outcomes were assessed over a 6–30 month follow-up period.

Key Findings:

• All procedures were completed pneumovesicoscopically without conversion to open surgery.
• In unilateral cases, there were no significant between-group differences in operative time (119.85 ± 29.13 vs. 116.21 ± 22.04 min, p = 0.437), estimated blood loss (6.15 ± 0.98 vs. 6.02 ± 0.91 mL, p = 0.454), duration of urethral catheterization (4.31 ± 0.59 vs. 4.53 ± 0.85 days, p = 0.112), length of hospital stay (6.34 ± 1.71 vs. 6.42 ± 0.93 days, p = 0.745), or complication rate (7.5% vs. 15.1%, p = 0.217). Similar findings were observed for bilateral cases (all p > 0.05). Surgical failure occurred in 2 ureters in Group P and 3 ureters in Group C, with an imaging-confirmed anatomical success rate of 98.1% in Group P and 96.3% in Group C.

Interpretation:

Pneumovesicoscopic ureteral reimplantation is a minimally invasive approach for pediatric VUR.

Limitations:

• The study is retrospective and may have inherent biases.
• Long-term outcomes require further validation.

Conclusion:

Although the Politano–Leadbetter technique is technically more demanding, it provides a more physiological ureteral course.