There has been great progress in ureteral surgery in the last twenty
years. The predominant indication is still calculous obstruction but
reparative and plastic surgery of the ureter for congenital and acquired
lesions are among the most interesting advances in modern urology. The
essential goal of this surgery is to ensure free flow of the urine from
the kidney to the bladder and so to preserve or improve kidney function
which is always affected or threatened by any defect in the excretory
pathway. The ideal is to re-establish a closed circuit flow from kidney
to bladder by repair or substitution of the ureteral conduit so as to
avoid as far as possible the dis- abilities that result from diversion
of the urine to the skin surface or to the intestine. This objective can
now be achieved in the treatment of most of the diseases of the ureter
when the relevant kidney is sufficiently healthy to merit conserva-
tion. The techniques used are not necessarily new but the advent of
antibiotics has made it possible to avoid or reduce the risks of
infection, pyelonephritis, or pyonephrosis that so often complicated
such surgery in earlier times. Progress in the investigation of renal
function and of the excretory tract has brought a better understanding
of the physio-pathology of the urinary apparatus and more accurate
judgement of the results of reparative surgery.