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Fig. 4A. —66-year-old man with ileal conduit and antirefluxing ureteroenteric anastomosis. Schematic diagram depicts creation of split-nipple antirefluxing ureteroenteric anastomosis. Ureter is cut longitudinally and folded back on itself to form a cuff (insert, 1 and 2). Distal ureteral cuff is inserted so that cuff protrudes into lumen of urinary reservoir. Distention of urinary reservoir causes walls of ureteral cuff to coapt, thereby preventing ureteral reflux.