[Viscus perforation as an unusual complication of Politano-Leadbetter ureteral reimplantation]

Abstract

Unusual complications of the Politano-Leadbetter ureteral reimplantation technique are reported in four ureters in three children with primary vesicoureteral reflux (VUR). These ureters were found to pass through an adjacent intraperitoneal viscus including the sigmoid colon, ileum or broad ligament. This complication occurred in 0.48% of the Politano-Leadbetter antireflux operations for primary VUR. Viscus perforation occurred only in children with a relatively high grade VUR. The prognoses of the hydroureter after ureteric reimplantation or ureterolysis, were good in all cases. Although there are several advantages in the transvesical procedure of the original Politano-Leadbetter method, we should not hesitate to go extravesically if there are difficulties in mobilizing the ureter or inducing it into the vesical cavity.