الفهرس 
The lower ureterOnly 14 pages are availabe for public view
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Abstract
Surgical interventions were performed for 308 patients (476 ureters). Most of our patients (74%) have primary reflux and 26% had secondary VUR. Extravesical reimplantation technique was performed in 188 patients (147 primary & 41 secondary), 90 patients (75 primary & 15 secondary) were injected by subureteral Macroplastique and 30 patients (6 primary & 24 secondary) were reimplanted intravesically. Extravesical ureteral reimplantation offers high success for correction of reflux (over 97%) in primary and secondary VUR, comparable results to the intravesical techniques. The ease of the technique, short hospital stay, and decrease urinary retention rate after technical improvement in bilateral surgery make it the preferred mode of correction of VUR In the Hospital for Sick Children, Toronto, Canada, when open surgical repair is indicated. The equivalent cure rate in refluxing duplex systems also makes it the preferred approach in this institution to correct reflux in these anomalies when indicated. The intravesical approach is reserved for patients who have associated pathology and need concomitant reconstructive surgery. Our data indicate that the higher grades of reflux were more likely to be associated with more significant hydronephrosis. Furthermore, surgery for correction of VUR resulted in a high-resolution rate of hydronephrosis, supporting the observed relationship. In our group of patients, persistent postoperative hydronephrosis did not require any intervention. Denovo hydronephrosis can be expected in more than 10% of open surgical cases of ureteral reimplantation but most will spontaneously resolve or remain mildly dilated and stable after one year of follow-up.