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The study of a series of 182 ureters (in 102 patients) treated in the Tripode Hospital, Bordeaux, highlights the following facts: as a diagnostic tool, cystography, if performed only once, is not reliable; on the other hand, isotopic cystography and endoscopic data are important adjuncts. As regards the management of these cases, 109 vesico-ureteric reimplantations were performed, 83 using Cohen's technique and 26 using Leadbetter's associated in some cases with a unicornous bladder. The results were excellent except in patients presenting with a severe renal insufficiency. Radical surgery was required in twenty cases. Fifty three patients were not treated surgically, but, when renal function is satisfactory, this attitude seems to offer more drawbacks than benefits.

Eight out of thirty five candidates for renal transplantation at the Bordeaux transplantation center, between 1975 and 1983, all presenting with primary vesico-ureteric reflux, underwent nephro-ureterectomy. The remaining twenty seven were not treated surgically. The authors consider that no operation is required when the ureter is narrow and uninfected, but that dilated refluant and infected ureters should be treated by nephro-ureterectomy, at least unilaterally. In that event, the operation is performed in two stages, with the second stage being performed at the same time as the transplantation.

After analyzing 39 cases, the authors go on to describe the virtues of surgical treatment of non-uric lithiasis after correct evaluation (lateral urography, CT scanning, retrograde ureteropyelography). The operative techniques draw considerable benefits from intraoperative radiography and, when necessary, the clamping of the renal pedicle under pharmacological protection. Surgical management offers the only possible means of preventing aggravation of the renal failure.