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The role of retrograde ureterography in the management of pelviureteric junction (PUJ) obstruction remains controversial and it has recently been reiterated that visualisation of the entire ureter on the affected side is mandatory owing to the high incidence of other ureteric abnormalities. In a review of 119 consecutive adult pyeloplasties carried out over a 9-year period, only 2 ureteric abnormalities were found in association with PUJ obstruction (duplex ureter/3-cm proximal stricture). Other anatomical abnormalities included aberrant vessels, fascial bands and renal anomalies. Most secondary abnormalities were undiagnosed prior to surgery and all were easily dealt with per-operatively.

Two cases are presented of reflux into a residual ureter causing recurrent urinary tract infection. A voiding cysto-urethrogram should be included in the investigative routines when nephrectomy for unilateral chronic pyelonephritis is planned. If severe reflux is seen, the entire ureter should be removed along with the kidney.

We review the complications and failures in our first 64 patients who underwent endopyelotomy. There were 2 intraoperative complications (3.1 per cent) necessitating an open operation. Postoperative complications included leakage around the stent or irritative bladder symptoms, which were treated by repositioning the stent, and 2 instances of ureterovesical stenosis, which have led us to stent the entire ureter in recent cases. There were 7 failures, 4 in patients who in retrospect were not suitable candidates for the percutaneous operation (long stenotic segment and redundant renal pelvis) and 3 for which there was no obvious cause. All failures were apparent soon after removal of the stent that was inserted at the end of the procedure.

A small isolated segment of ileum was used to replace a portion of the ureter in 3 patients with the distal anastomosis being performed to the intact ureteral stump. The ileal interposition rather than replacement of the entire ureter, takes advantage of the presence of a normal, non-refluxing ureterovesical junction and serves to diminish any potential problems with electrolyte disturbances.

The function of the male renal sex segment secretions in the adder, Vipera berus, was studied. Renal sex segments in male adders were hypertrophied immediately before and during the mating period. Simultaneously, renal secretion was found in the entire ureter and coprodeum. Newly mated females have long, slightly convoluted, and hard posterior uteri, while females prior to mating, and nonreproductive ones, have weakly contracted or flaccid uteri. Uteri in newly mated females had a contracted sphincter muscle with reduced and compressed folded lumen. Uteri in an estrous female supplied with vital stained renal secretion became hard posteriorly. The stained secretion reached the entrance of the uteri, where the hard parts started. Estrous females artificially supplied with male sex secretion showed a significant decrease in acceptance of male courtship. Administration of renal sex secretion also interfered with reproduction.

Four cases of primary ureteral tumour are presented. The significance of cytologic examination of the urine and complete visualization of the entire ureter by either intravenous or retrograde urography is stressed.