The Reflux-preventing Reimplantation of Large Ureters Without “Reduction Tailoring”

Abstract

The surgical prevention of vesico-ureteric reflux (VUR) after the reimplantation of normal-calibre ureters into the bladder is generally dependent upon the creation of an intravesical-pressure-operated mechanical valve. This may take the form of either:

• 1. A submucosal tunnel of appropriate length, in which case the valvular occlusion created by a rise in intravesical pressure is achieved by its compression against the underlying support of the bladder wall, or

• 2. A cuffed nipple of appropriate length to ensure valvular occlusion on its lumen by a circumferential intravesical pressure rise (Turner-Warwick and Ashken 1967).