title: [New surgical intervention for correction of vesico-ureteral reflux. Current status].
abstract: Vesicoureteral reflux (VUR) with urinary infection is a major risk factor which leads to End-stage renal disease and high blood pressure in between 3 and 25% of children and between 10 and 15% of adults. Classical techniques for the correction of VUR are very aggressive given the delicate structure of terminal ureter and they have the disinsertion of the ureteovesical junction, the extensive dissection and mobilization of the ureter, the creation of a new hiatus, the formation of a submucosal tunnel and the reimplantation of the ureter in common. They are very aggressive techniques and create the risk of complications such as obstruction due to ischemia and contralateral reflux. The new technique that we described in 1984 is based on preserving the anatomical and functional integrity of the terminal ureter. The ureters remain intact; they are only slid and moved to the midline of the trigone with a simple maneuver where they are fixed with one stitch, bloodlessly recovering a greater submucosal trajectory ad good muscular support. More than 25 years of experience worldwide have made the appraisal unanimous in considering it as the simplest, fastest, most effective and less invasive technique whili highlighting the absence of complications. This supports its use as one of the primary options in the treatment of VUR, giving rise to new applications of the procedure such as in secondary VUR in neurogenic bladders and in reflux in ureteral duplication.
authors.forename: José María
authors.initials: JM
authors.lastname: Gil-Vernet Vila
mesh_terms: D006801:Humans; D013520:Urologic Surgical Procedures / Q000379:methods; D014718:Vesico-Ureteral Reflux / Q000601:surgery*