Endoscopic trigonoplasty for primary vesico-ureteric reflux.

OBJECTIVE: To investigate the surgical results of endoscopic trigonoplasty in patients with primary vesicoureteric reflux.

PATIENTS AND METHODS: Records were reviewed for 12 patients who underwent endoscopic trigonoplasty between February 1992 and February 1994. Of the 12 patients, 11 were female; one was a child and nine had unilateral disease. From 15 renoureteric units, grade I vesico-ureteric reflux was demonstrated in five, grade II in six and grade III in four. The ureteric orifices were approximated close to the midline via the urethral route and two trocars on the abdomen achieved pneumobladder.

RESULTS: The mean surgical time was 178 +/- 52 min; this lessened as the learning curve developed. Intra-operative complications in three patients were all caused by trocar placement. Eleven patients required analgesics for one post-operative day only. No post-operative dilatation of the upper urinary tract was demonstrated. Vesico-ureteric reflux was eradicated in all patients.

CONCLUSIONS: Endoscopic trigonoplasty is a minimally invasive procedure with a high cure rate. By not destroying the normal vesico-ureteric junction, post-operative obstruction cannot occur. We believe that endoscopic trigonoplasty is a feasible procedure for patients with vesico-ureteric reflux.