The Use of Lower Ipsilateral Ureteroureterostomy to Treat Vesicoureteral Reflux or Obstruction in Children with Duplex Ureters

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Abstract
During the last 4 yr lower ipsilateral ureteroureterostomy was performed to treat vesicoureteral reflux and/or obstruction in 11 children with 13 completely duplicated systems. There was reflux only to the lower segment in 11 systems, obstruction only to the upper segment in 1 and reflux with obstruction in 1 system. The procedure is technically easier than ureteroneocystotomy, avoids cystotomy and permits a brief postoperative hospitalization. The postoperative excretory urogram demonstrated improved or stable hydronephrosis in all patients. Vesicoureteral reflux persisted in 1 system associated with a golf hole orifice. Caution should be exercised when children with reflux in duplex systems associated with a golf hole ureteral orifice are treated.