The 5:1 rule overestimates the needed tunnel length during ureteral reimplantation.
Kourosh M KalayehJ Brian FowlkesWilliam W SchultzBryan S SackPublished in: Neurourology and urodynamics (2020)
Our modeling results are consistent with Paquin's original observation on the significance of the UVJ length-to-diameter ratio in preventing reflux. They, however, indicate that the surgical implementation of this rule during UNC results in an overestimation of the requisite tunnel length-to-diameter ratio to prevent reflux. They also suggest that the UVJ closure is due to the bladder wall deformation rather than the pressure.