[Experience of extravesical dismembered antireflux surgery]

Thirty-eight patients (61 ureters) with primary vesicoureteral reflux who underwent extravesical antireflux surgery between Jan. 1975 and March 1989 were retrospectively analyzed. The overall postoperative vesicoureteral reflux (VUR) disappeared in 81.6% (31/38) of the patients, 86.9% (53/61) of the ureters. Among patients under 8 years old, VUR disappeared in all but one ureter. The postoperative VUR the disappeared in 95.7% (22/23) of the patients, 97.2% (35/36) of the ureters. Early postoperative early complications, including macrohematuria and bladder irritation were significantly fewer than those occurring in patients treated by the intravesical method. There were no serious late complications. Under restricted indications for patients under 8 years old, extravesical antireflux surgery might be clinically useful for treatment of VUR. Through the re-evaluation of length of submucosal tunnel, surgical outcome of this procedure might be improved.