Technical considerations in distal tunnel ureteral reimplantation.

The advantages of a distal tunnel ureteral reimplantation have been elaborated upon previously. This method offers simplicity of transvesical explosure, rapidity of execution, excellent visibility of the terminal ureteral segments, minimal dissection and trauma in the paravesical space, the opportunity to advance the ureteral orifices to a physiologic position on the trigone and minimal risk of angulation, kinking or obstruction of the terminal ureter. It is now recognized that this method, with the modifications discussed herein, has wide applicability in the management of vesicoureteral reflux of all varieties and etiologies.