Reflux in complete duplication in children

Reflux is the most common abnormality associated with complete ureteral duplication. Several authors have emphasized early surgical correction of reflux when it occurs in duplicated systems because of a negligible success rate in non-operative therapy. Our practice has been to judge an orifice with reflux on its own merit, that is position, appearance and submucosal tunnel length. Realizing that this philosophy is not in total agreement with most of the literature on reflux in ureteral duplication we have reviewed 59 cases to ascertain whether our non-operative approach has justification. In this study early operation was elected in 61 per cent of those patients with reflux in association with total duplication. However, in 48 per cent of patients followed with non-operative surveillance reflux has either stopped spontaneously or is medically stable.