Louis Auguste Mercier (1811-1882).
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Biomedical subjects
Publications and source records attributed to C B Manley.
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Detailed cystoscopic grading of ureteral orifices has proved unnecessary in our experience for determining the prognosis of moderate, primary reflux in girls. Medially placed orifices strongly predict spontaneous resolution with preventive medication, while radiographic pyelonephritic scarring and/or grade III reflux strongly predict failure to resolve. While laterally placed ureteral orifices and low volume reflux suggest a need for operation, they are prognostically less useful, particularly when those with grade III reflux are excluded. Cystitis cystica and unrelated anomalies seem to be associated with the ultimate need for operation but are of uncertain significance.
Pronounced ureteral obstruction following an antireflux operation is an uncommon but often difficult problem to manage. Based on a limited experience we have found that triangular flap ureteroplasty is a worthwhile means of repeat reimplantation of the obstructed ureter and perhaps provides a better alternative than transureteroureterostomy.
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