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Extravesical detrusor tunneling: a variant of antireflux procedure.

Detrusor tunneling procedure is an extravesical technique, which provides antireflux implantation of different tube systems (ureter, appendix, tubularized preputial flap, tapered ileum). The main characteristic of the technique is the formation of extravesical submucosal tunnel by creating a bridge from the unresected bladder muscle under which the tube is passed. During the period from January 1987 to July 1995, the technique was performed on 442 different tube systems: 402 ureters, 12 appendices, 26 tubularized preputial flaps and 2 tapered ileums. Patients were aged from 15 days to 42 years (mean 39 months). Follow-up was from 2 months to 8 years (mean 2.9 years). Postoperative complications occurred in 11 cases. There were 3 stenoses and 5 refluxes in ureteroneocystostomies, and one stenosis and 2 urine leakages in continent cutaneous vesicostomies. The extravesical detrusor tunneling procedure could be a very useful method for antireflux implantation of various tube systems.