Reconstruction of the ureter: a review of operative and functional aspects

The importance of the urodynamic characteristics of the ureter are considered after plastic and reconstructive operations. Choice of the most suitable method is as important as good operative technique. The partial replacement of the lower end of the ureter by a bladder flap shows good results. Different types of bladder flap procedures do not influence the dynamics of the ureter as its continuity is preserved. Irrespective of the material used, failures of autoplastic or alloplastic segmental replacement are due to the lack of functional adaptation of the prostheses. By partial replacement good results may be obtained if vesico-ureteral reflux is avoided.