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Purpose To report our initial experience with a modified ureteral orthotopic reimplantation technique under pneumovesicum and compare the outcomes vs. those obtained with the Cohen technique under pneumovesicum for the correction of primary obstructive megaureter (POM) or vesicoureteral refluVUR) in pediatric patients. Methods A total of 46 patients (38 POM and 8 VUR; mean age 16.24 months) treated with modified ureteral orthotopic reimplantation (OR) and 43 patients (34 POM and 9 VUR; mean age 22.98 months) treated with Cohen reimpl