Ureteral tailoring in situ: a practical approach to persistent reflux in the dilated reimplanted ureter.

PURPOSE: We evaluated a new simplified technique for secondary surgical correction of persistent reflux in a reimplanted dilated ureter. MATERIALS AND METHODS: Four patients a median of 3 years old with recurrent vesicoureteral reflux after initial reimplantation of ureters greater than 9 mm. in diameter underwent in situ excisional ureteral tailoring. RESULTS: Followup ranged from 15 to 27 months (mean 22). Within 3 months postoperatively ultrasound confirmed no ureteral obstruction, and at 3 to 6 months voiding cystourethrography revealed no vesicoureteral reflux in any case. CONCLUSIONS: Our study highlights the surgical details and safety of this technique for preserving the vascularity of the reconstructed ureter and avoiding injury to the contralateral ureter.