OBJECTIVE: To report our functional results of the "flap-and-trough" (FT) antireflux uretero-intestinal anastomosis (UIA) applied to various forms of urinary diversions. PATIENTS AND METHODS: From April 1998 through March 2003, a total of 49 ureters were implanted in 28 patients into various types of urinary diversions. Forty-six ureters were implanted transluminally (32 separately, 14 conjointly by the double-barrelled method), 3 ureters extraluminally into preformed reservoirs during kidney transplantation. Forty-one ureters were implanted primarily, 8 ureters secondarily due to stricture of former UIA. RESULTS: Median observation time was 26 months. The healing was uneventful in all cases. Late complications were not related to the UIA. Twenty-four patients could be evaluated. The upper urinary tract remained stable, no reflux and no stenosis at the site of UIA were detected. FT anastomoses were clearly seen and easily accessible at endoscopy. CONCLUSION: In our hands the FT anastomosis has proved to be simple, safe and highly effective in terms of protecting the upper urinary tract against obstruction and reflux. Creation of antireflux UIA need not mean increased risk of obstruction in comparison with direct (reflux) ones. The FT technique could represent another alternative of nonrefluxing implantation of normal as well as dilated ureters into various types of urinary diversion.

Institution of Traumatology Brno Masaryk University School of Medicine Brno Czech Republic

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