Considering current pathogenetical knowledge on reflux nephropathy and clinical experience with urinary diversions, it is impossible to arrive at a definitive conclusion on the necessity of reflux preventing techniques in urinary diversion. The decision has to take into account the apparent hazards of reflux in a given diversion and the apparent hazards of preventing reflux with that diversion. Whereas reflux prevention in high-pressure reservoirs and in continent diversion with cutaneous stomy is widely justified, there is no objective evidence to support the need for reflux prevention in urinary diversion with low-pressure bladder substitutes with sterile urine.
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