2025 Volume 61 Issue 2 Pages 138-146
In the field of urology, diagnoses have traditionally been made using rigid instruments such as cystoscopes. With the development of endoscopic equipment, transurethral surgery has advanced. In pediatric urology, transurethral surgery is frequently performed for the treatment of bladder tumors, bladder stones, urethral stones, ureteroceles, and posterior urethral valves. Vesicoureteral reflux (VUR) prevention surgery has long been centered on open surgery, but the advent of endoscopic injection therapy and pneumovesicoscopic surgery has expanded treatment options. In 2024, laparoscopic surgery using an extravesical approach was covered by medical insurance in Japan. In the near future, if robotic surgery is covered by medical insurance, it is expected that VUR prevention surgery will undergo significant changes. Within this context, the role of pneumovesicoscopic surgery is also expected to evolve. For conditions such as megaureter, ureterocele, and ectopic ureter, intravesical manipulation and approaches to the posterior bladder wall via the bladder are considered effective and safe, thus maintaining the value of pneumovesicoscopic surgery.
