Cohen Transtrigonal Ureteric Reimplantation without Ureteric Splint or Cystostomy Drains

Objective: To review our experience in the outcome of children undergoing Cohen transtrigonal ureteric reimplantation without cystostomy tube or ureteric splint, just to keep urethral drain (Foley’s) for 48 hours. Material and Methods: Between July 2001 and July 2008, 67 patients who underwent ureteric reimplantation at King Hussein Medical Center and Queen Alia Military Hospital were included in this study. Those patients who needed extensive dissection, ureteric tapering, or had thickened bladder wall or neuropathic bladder were excluded. Data recorded included the procedure, operative and post operative pain, hospital stay, post hospital discharge problem and operative success. Results: 67 patients 46 females, and 21 males, with mean age of 7.8 years (range from 1 to 14 years) there were 25 bilateral and 42 unilateral reimplantations, only Foley’s catheter left in and no uretral stent or cystostomy drains were placed which was removed on the second post operative day. Caudal anaesthetic, oral and rectal analgesia were used for pain relieve, and all patients were discharged home within 48 hours of surgery. Conclusion: Surgical repair of vesico-ureteric reflux can be successful with early bladder catheter removal and without ureteric splint or cystostomy drains and appears to be significant decrease in the hospital stay and discomfort after surgery.