[The technique of ureteric advancement in vesico-ureteric reflux (author's transl)]

The authors, anxious about the crossed position of the ureteric meatuses after transverse submucosal advancement of the ureters, prefer descending submucosal advancement. They emphasise the widely open nature of the hiatus of penetration of the ureter into the bladder. Tightening of this orifice, distal to the orifice left free for the penetration of the ureter, participates in elongation backwards of the muscular layer upon which the submucosal advancement will take place. If necessary, if the trigone is too short, the vesical muscularis layer is slit in a proximal direction, uretero-vesical penetration withdrawn by an equal amount and suture of the muscular breach behand the ureter elongates a submucosal course which, without the use of this technique, would be too short. The authors have collected a series of 63 ureters. No stenosis, 3 residual reflux and at the time of follow up cystoscopy where applicable, the new meatus is easy to locate and to catheterise.