Reimplantation of the wide ureter

A modification of the technique of Politano and Leadbetter for reimplantation of wide ureters is described. Nine patients with obstructive megaureter (10 ureters) and 6 with gross vesicoureteric reflux (9 ureters) were treated. A satisfactory result was obtained in 6 of the obstructed patients (7 ureters) and ultimately, after re-operation, in 1 of the remaining ureters. Reflux was corrected in all 6 patients. This method requires less extravesical dissection than others involving extensive remodelling of the wide ureter. There is therefore less risk of damage to the distal ureteric blood supply and the natural flap valve mechanism at the ureteric orifice may be more effectively emulated.