ABSTRACT
The need for reflux prevention in adult urinary diversion is controversial. A detailed discussion of the evidence for it is presented in Chapter 31. The techniques for reflux prevention during ureteral reimplant into small bowel include the intussuscepted ileal nipple valve, the ureteric split-cuff nipple valve, the afferent tubular segment, various tunneled anastomoses and the Le Duc-Camey tunnel. Techniques for antireflux anastomosis into large bowel consist almost entirely of some type of a tunneled anastomosis. This chapter will cover the intussuscepted nipple valve and tunnel techniques for the prevention of reflux. The other techniques are outlined elsewhere in this book. Both of these have undergone significant modifications since their initial introduction and continue to be used in routine urologic practice.
