Bilateral or unilateral ureteroneocystostomy for unilateral reflux

Thirty-five cases of unilateral reflux treated by ipsilateral ureteroneocystostomy have been reviewed to determine the incidence of subsequent contralateral reflux. The low incidence (11 per cent) suggests that bilateral reimplant should not be performed routinely in patients undergoing surgery for unilateral reflux. Analysis of this group of patients failed to show any preoperative findings which would help to predict those in whom contralateral reflux is most likely to develop. Our study and the review of the literature suggest that those who demonstrate reflux in the contralateral ureter at any time prior to surgery are more likely to reflux subsequently; therefore, in this group of patients bilateral reimplantation is indicated.