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  • Title: [Cohen's operation in the treatment of vesico-ureteral reflux in children].
    Author: Pugachev AG, Pavlov AIu, Alferov SM, Kuznetsov VM.
    Journal: Urol Nefrol (Mosk); 1989; (1):26-9. PubMed ID: 2655252.
    Abstract:
    The present study is a review of the results of Cohen's operation performed on 43 ureters in 32 children. Treatment results were assessed through the comparison of cystographic and 131I-hippuran renographic findings obtained before and after surgery. Urodynamic recovery in the affected ureter was demonstrated in all children. One year after surgery, there was no improvement in the activity of the resected kidney in 37% of patients. In the remaining patients, secretion improved by 10-13% in the affected kidney. Seventeen children returned for follow-up examination 2 years after surgery. The activity of the affected kidney and the contralateral one improved in 13 of 17 patients. There was no upper urinary retention due to ureteral stricture in any of the children. The rate of recurrent vesico-ureteral reflux (VUR) was 5.3%. Augmentation or persistence of purification deficiency in the affected kidney, detected in 12 patients at first postoperative follow-up, was qualified as a result of aggravated chronic pyelonephritis rather than that of surgical complications related to methodologic specifics. This assumption was verified by the results of the next follow-up examination 2 years after surgery. Therefore, Cohen's method can be recommended for large-scale application in the treatment of VUR in children and is expected to essentially reduce the rate of relapses and improve the standards of surgical care of children with this grave disease.
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