Transverse Ureteral Advancement Technique of Ureteroneocystostomy (Cohen Reimplant) and a Modification for Difficult Cases (Experience with 121 Ureters)

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Abstract
Ureters were reimplanted by the Cohen technique. A modification is introduced for difficult cases, making the Cohen technique more adaptable for dilated ureters and small bladders. Radiographic studies obtained at least 6 mo. after reimplantation revealed only 1 case of peristent reflux (grade I), no case of contralateral reflux and no obstruction. Even though the series included 35 ureters with grade V primary reflux and 7 primary obstructive megaureters, only 7 ureters were tapered. The Cohen method might require tapering in a smaller percentage of cases compared to other reimplantation techniques.