Detrusorrhaphy for the repair of vesicoureteral reflux: comparison with the Leadbetter-Politano ureteroneocystostomy.

The authors report their surgical experience for 56 patients (81 ureters) with vesicoureteral reflux using either the extravesical (detrusorrhaphy) approach or the Leadbetter-Politano (intravesical) procedure. The success rate was the same in both. Patients undergoing the extravesical approach required less pain medication and less anticholinergic therapy to control bladder spasms in the postoperative period as compared with the patients undergoing the repair through an intravesical approach. Because the bilateral extravesical approach may be associated with transient urinary retention, the authors recommend that bilateral procedures be performed with minimal dissection of the trigone or that this approach be limited to unilateral repair.