KẾT QUẢ PHẪU THUẬT ĐIỀU TRỊ LUỒNG TRÀO NGƯỢC BÀNG QUANG – NIỆU QUẢN NGUYÊN PHÁT BẰNG KỸ THUẬT COHEN TẠI BỆNH VIỆN NHI TRUNG ƯƠNG

Abstract

Objective: The study was aimed to evaluate the results of Cohen technique in the treatment of primary vesicoureteral reflux at the National Children’s Hospital. Material and methods: A retrospective case series, 46 patients diagnosed with primary vesicoureteral reflux who underwent surgical treatment with the Cohen procedure at the Department of Urology, National Children’s Hospital, from January 2020 to June 2024. Results: The mean age was 39 months (range 9 –140 months). The proportion of female patients was 26.1%. The majority had recurrent urinary tract infections (UTIs) at 80.4%. Positive urine cultures were found in 34.8%, among which Escherichia coli was the most prevalent pathogen at 37.5%. All cases involved bilateral vesicoureteral reflux (VUR). Moderate (grade III) and severe (grades IV-V) VUR accounted for the majority (97.8%). The rate of small kidneys detected by ultrasound was 37%, and the rate of upper urinary tract dilation was 56.5%. Among patients who underwent renal scintigraphy, the rate of renal damage was 66.7%. The average operation time was 97.8 ± 21.7 minutes (range 60–160 minutes). The average postoperative hospital stay was 6.5 ± 1.6 days (range 5–13 days), and the average time to remove the double-J stent was 36.8 ± 9.8 days (range 21–62 days). Early complications included 4 cases of febrile urinary tract infection and 1 case of double-J stent displacement complicated by Candida tropicalis infection. Long- distance monitoring: no cases of febrile urinary tract infection were recorded; 3 cases still had positive urine leukocytes but without clinical signs of infection. Postoperative urinary tract dilation decreased, with 7/46 cases (15.2%) remaining. Postoperative cystography after surgery was 18/46 cases (39.1%), showing a reflux resolution rate of 94.4%. Conclusion: The Cohen ureteric reimplantation under a common submucosal tunnel was safely and effectively in the treatment of primary vesicoureteral reflux.