Vesicoureteral Reflux.- A. Definition of Reflux.- B. Anatomy of the Ureterovesical Junction.- I. Contribution of the Ureter and Trigone to the Formation of the Ureterovesical Junction.- II. The Vesical Component of the Ureterovesical Valve.- 1. The Mucosal Layer.- 2. The Inner Longitudinal Muscle Layer.- 3. The Middle Circular Muscle Layer.- 4. The Outer Longitudinal Muscle Layer.- C. Innervation.- D. Physiology of the Ureterovesical Valve.- I. The Effect of Interrupting the Anatomical Continuity between the Ureter and the Trigone.- II. The Effect of Cutting the Nerves that Supply the Trigonal Muscle.- III. The Effect of Active Contraction of the Trigone on the Resistance of the Intravesical Ureter.- IV. The Effect of Active Contraction of the Trigone in Tightening and Occluding the Intravesical Ureter during Voiding.- E. Pathology of the Ureterovesical Junction.- I. Structural Changes at the Ureterovesical Junction.- 1. Conditions in which the Ureteral Hiatus Moves Downward in Relationship to the Ureteral Orifice.- 2. Conditions in which the Ureteral Orifice Moves Upward in Relation to the Ureteral Hiatus.- II. The Effect of Vesical Edema on the Ureterovesical Junction.- III. Congenital Anomalies of the Ureter.- IV. Maturation of the Intravesical Ureter.- V. Concept of the Marginally Competent Ureterovesical Junction.- F. Classification of Reflux by Etiology.- I. Reflux Due to Trigonal Weakness.- II. Reflux Due to Obstruction at or below the Bladder Neck.- III. Reflux Due to Neurogenic Vesical Disease.- IV. Reflux Due to Edema of the Bladder Wall.- V. Reflux Due to Congenital Anomalies.- VI. Reflux Due to Iatrogenic Causes.- G. Etiology of Nonocclusive Ureteral Dilatation (Megaloureter).- I. Factors that Increase the Volume of Urine in the Ureter.- 1. Dilation of the Renal Pelvis and Ureter by Forced Intake of Fluids.- 2. Dilation of the Upper Urinary Tract Due to Diabetes Insipidus.- 3. Dilation of the Pelvis of a Kidney Forced to Increase its Output after Unilateral Nephrectomy.- 4. Reflux as a Cause of Ureteral Overfilling.- II. Emptying Capacity of Various Areas of the Ureter.- III. Reflux and the Ureteropelvic Junction.- IV. Reflux and the Ureterovesical Junction.- H. Incidence of Reflux.- I. High Incidence of Reflux in Children with Urinary Tract Infection.- II. Demonstration of Reflux in Adults with Nonobstructive Pyelonephritis.- I. Effects of Reflux.- I. The Role of Reflux in Obstruction at the Ureteropelvic Junction.- II. The Kidney with Chronic Pyelonephritis.- III. The Atrophic Kidney with Chronic Pyelonephritis.- IV. The Normal Kidney.- V. Reflux as the Cause of Pyelonephritis of Pregnancy.- VI. Role of Reflux in the Perpetuation of Urinary Tract Infection.- VII. Miscellaneous.- J. The Role of the Ureterovesical Junction in the Pathogenesis of Pyelonephritis.- I. Childhood.- II. The Teenage Period.- III. The Adult Period.- IV. Prostatic Period.- K. The Treatment of Reflux and its Complications.- I. Medical Treatment.- II. The Surgical Correction of Reflux.- 1. Types of Operation.- 2. Results of Operation.- 3. Indications for Operation.- a) The Severity of the Reflux.- b) The Presence of Saccules.- c) The Severity of the Clinical Course.- d) The Conditions of the Kidneys.- e) The Age of the Patient.- References.- Anomalies of the Kidney.- I. Agenesis.- a) Bilateral Renal Agenesis.- b) Solitary Pelvic Kidney.- II. Hypoplasia.- a) Unilateral.- b) Bilateral.- III. Cystic Disease.- a) Simple (Solitary) Cysts.- b) Multiple Cysts of the Kidney.- c) Multilocular Cysts.- d) Polycystic Kidney Disease.- e) Peripelvic Cysts.- IV. Fusion Anomalies of the Kidney.- a) Horseshoe Kidney.- b) Unilateral Fused Kidney.- c) Fused Pelvic Kidney.- V. Ectopia of the Kidney.- 1. Introduction.- 2. Classification.- a) Simple Ectopy.- b) Bilateral Ectopia.- c) Crossed Renal Ectopia.- d) Ectopic Pelvic Kidney.- e) Thoracic Kidney (Congenital Superior Ectopia).- VI. Anomalies of Rotation.- 1. Introduction.- 2. Embryology.- 3. Incidence.- 4. Etiology.- 5. Symptoms and Diagnosis.- 6. Treatment.- VII. Anomalies of the Vessels.- 1. Introduction.- 2. Production of Hydronephrosis by Aberrant Vessels.- 3. Incidence.- 4. Symptoms.- 5. Diagnosis.- 6. Treatment.- VIII. Supernumerary Kidney.- 1. Introduction and Incidence.- 2. Pathogenesis.- 3. Symptoms.- 4. Diagnosis.- 5. Treatment.- IX. Cystic Disease of the Renal Pyramids.- 1. Definition and Historical.- 2. Incidence.- 3. Etiology.- 4. Pathology.- 5. Clinical Considerations.- 6. Diagnosis.- 7. Treatment.- 8. Prognosis.- X. Anomalies of the Renal Pelvis.- 1. Incidence.- 2. Embryological Development.- 3. Clinical Considerations.- 4. Differential Diagnosis.- 5. Treatment.- Acknowledgments.- References.- Anomalies of the Ureter.- A. Multiplication, Ectopia and Ureterocele.- I. Ureteral Duplication (and Triplication).- 1. Definitions.- 2. Incidence (Table 1).- 3. Embryology and Physiology.- a) Embryology.- b) Physiology.- 4. Surgical Anatomy.- 5. Associated Anomalies.- 6. Associated Reflux.- 7. Associated Disease.- 8. Clinical Aspects.- a) Symptoms.- b) Diagnosis.- ?) Personal History.- ?) Family History.- ?) Physical Examination.- ?) Laboratory Study of the Urine.- ?) Excretory Urography.- ?) Cystoscopy.- ?) Vaginoscopy and Urethroscopy.- ?) Other Radiographic Techniques.- c) Principles of Management.- ?) Incomplete Ureteral Duplication.- ?) Complete Ureteral Duplication.- ?) Triplication or Quadruplication.- II. Ureteral Ectopia.- 1. Definition and Description.- 2. Sites of Ectopic Orifices.- 3. Incidence.- 4. Associated Anomalies.- 5. Clinical Features.- a) Incontinence.- b) Obstruction and Dilatation.- c) Infection.- 6. Diagnosis.- a) History.- b) Family History.- c) Physical Examination.- d) Urinalysis.- e) Urographie Procedures.- ?) Excretory Urography.- ?) Micturition Urethrocystography.- ?) Vasography.- f) Endoscopy.- 7. Treatment.- III. Ureterocele.- 1. Definition, Description, Types.- 2. Incidence.- 3. Pathogenesis.- 4. Associated Anomalies and Disease.- 5. Clinical Manifestations.- 6. Reflux.- 7. Diagnosis.- a) Urography.- ?) Excretory Urography.- ?) Retrograde Urethrocystography.- b) Endoscopy.- 8. Treatment.- a) Simple Ureterocele.- b) Ectopic Ureterocele.- B. Ureteropelvic Junction Obstruction.- 1. Definition and Description.- 2. Incidence.- 3. Causes.- a) Aberrant Renal Blood Vessels.- b) Adhesions and Kinks.- c) High Insertion of Ureter.- d) Stenosis.- e) Functional Disorders.- f) Vesicoureteral Reflux.- 4. Clinical Aspects.- a) Superimposed Intermittent Acute Obstruction.- b) Recurrent Pyelonephritis with Loin Pain.- c) Renal Calculi.- d) Hematuria.- e) Trauma.- f) Associated Hypertension.- 5. Diagnosis.- 6. Treatment.- C. Unusual Positions of the Ureter.- I. Retrocaval (Post-caval; Circumcaval) Ureter.- 1. Definition.- 2. Incidence.- 3. Embryology.- 4. Clinical Aspects.- a) Symptoms and Signs.- b) Diagnosis.- c) Treatment.- II. Retroiliac Ureter.- III. Herniation of the Ureter.- D. Agenesis, Aplasia, Blind Ending.- I. Agenesis.- II. Aplasia.- III. Blind Ending Ureters.- E. Congenital Dilatation of the Ureter.- I. With Obstruction.- 1. Congenital Ureteral Stricture.- 2. Distal Ureteral Atresia.- 3. Congenital Ureteral Valves (or Folds).- II. Without Obstruction.- F. Twists, Kinks, Congenital Diverticula, Blockage by Vessels.- I. Spiral Twist or Torsion of Ureter.- II. Ureteral Kinks.- III. Diverticulum of the Ureter.- IV. Blockage of the Ureter by Blood Vessels.- References.- Congenital Abnormalities of the Bladder.- A. Development of the Bladder.- I. The Cloaca.- II. The Genital Tubercle.- III. Separation of the Bladder from the Intestinal Tract.- IV. Formation of the Trigone.- V. Regression of the Allantoic Duct.- VI. Development of the Bladder Musculature.- VII. Fetal Descent of the Urinary Tract.- VIII. Summary of Important Early Developmental Events.- B. Congenital Abnormalities of the Bladder.- I. Agenesis of the Bladder.- 1. Incidence.- 2. Pathology.- 3. Treatment.- II. Urachal Abn…