Results of the Gil Vernet procedure in preventing contralateral reflux in unilateral ureteric reflux

Objective To evaluate whether contralateral meatal advancement based on the technique described by Oil Vernet decreases the risk of postoperative cont ralateral reflux, which may occur after a unilateral reimplantation. Patients and methods From January 1986 to 1997, 321 reimplantations were pe rformed for unilateral vesico-ureteric reflux (VUR) using the Cohen procedu re, In cases where the contralateral meatus was symmetrical. or had a patho logical appearance. preventive contralateral surgery with meatal advancemen t alas performed. Results Ureteric reimplantation was exclusively performed unilaterally in 2 54 patients and in 67 a contralateral meatal advancement was performed. The re were 29 cases of contralateral reflux at the 4-month follow-up, In nine patients contralateral reimplantation was necessary for persistent symptoma tic VUR, the reflux resolved spontaneously in 14 and a radiological examina tion was necessary in six. Reflux also appeared on the Gil Vernet side in o nly 6% of patients, there were no clinical symptoms and the outcome was fav ourable. Conclusion The advancement of the meatus using the Gil Vernet procedure is simple, with no surgical complications. We suggest that this technique cons titutes a useful surgical alternative in the prevention of contralateral re flux.