Antireflux ureteroileal anastomoses in humans.

It is now apparent that the standard total cystectomy and Bricker procedure, by eliminating the ureterovesical junction with its reliable antireflux mechanism, markedly reduces the protection of the upper urinary tracts. In an attempt to restore this protective principle, the subserosal ileoureteral antireflux procedure was devised and subsequently performed in 6 patients with infiltrating bladder carcinoma. The operation is technically easy to perform, it is not time consuming and has consistently prevented ileoureteral relux without causing obstruction. There have been no serious complications, no episodes of pyelonephritis or urinary leakage and no evidence of renal functional deterioration as measured by serum creatinine and IVP. Although it is still to early to predict the eventual long-term results our experience with the first 6 patients with the antireflux ileoureteral anastomosis suggests that this modification of the original Bricker procedure offers superior protection to the upper urinary tracts.