[Vesico-renal reflux in adults. Study of 57 ureters reimplanted by the submucosal advancement method]

Vesicorenal reflux raises specific problems in adults, as regards both the surgical indications and the operative technique. The operative results are discussed in relation to fifty seven ureters reimplanted in thirty six patients, and the indications for surgical management are outlined. Refluxes clinically associated with lumbalgia, fever and pyuria, always require surgery. The most difficult problems arise from "asymptomatic" refluxes revealed by checkups for renal insufficiency, proteinuria or arterial hypertension. In these cases, the characteristics of the ureter (e.g. wide or narrow) and the existence or absence of renal scars must be taken into consideration. Refluxes in narrow ureters should be followed closely, and the advisability of surgery should be carefully weighed in patients with a wide ureter with no visible damage to the parenchyma.