Purpose of review The challenge of bridging long defects of ureter has been reviewed with particular emphasis on the utilization of ileum. Recent findings The application of the Yang-Monti principle can provide an ileal tube of adequate length and suitable cross-sectional diameter. An antireflux ileovesical anastomosis is also feasible. Summary Although long-term results are still lacking, an ileal tube constructed on the basis of the Yang-Monti principle seems ideal for ureteric substitution.