Use of the Mainz pouch II technique leads to a reduction in the complications frequently observed because of the high pressure associated with ureterosigmoidostomy. A technical variation of the procedure is described in which reimplantation of the left ureter in the rectosigmoid is carried out to avoid the risk of stretching and kinking and the need to fix the pouch to the sacrum. Furthermore, this procedure is easier to perform and less time consuming.