The flap-valve T mechanism in the T pouch provides an effective and reliable antireflux technique. The long-term results of the T pouch are yet to be determined; however, initial and early results have been excellent. This technique can be learned with a little experience. The T mechanism is a versatile flap-valve technique that can also be applied as a continent mechanism in a cutaneous reservoir (double T pouch). Reconstructive surgeons interested in lower urinary tract reconstruction should understand this concept and technique to broaden their surgical armamentarium.