Repair of iatrogenic ureteral injury with a combination of ‘’Boari flap’’ and ‘’Psoas Hitch’’ technique

Lazaros Tzelves, Marinos Berdempes, Titos Markopoulos, Lazaros Lazarou, Maria Zerva, Alexandros Pinitas, Nikolaos Xatzikraxtis, Iraklis Mitsogiannis, Euaggelos Karagiotis, Andreas Skolarikos

Abstract


A common cause of ureter trauma is iatrogenic, especially during
gynecologic and obstetric procedures. Early diagnosis is of vital
importance for the successful management of these patients
and depends on the type, anatomic location and length of ureteral
deficit. Preoperative placement of ureteral stent does not
seem to reduce incidence of these cases. For extended length
traumas, surgical techniques like Boari flap and Psoas hitch have
been reported, in order to reconstruct ureter and accomplish
ureteroneocystostomy. We describe the case of a patient, who
presented with a deficit of 13 cm after sigmoidectomy. We performed
a combination of Boari flap and Psoas hitch successfully
and restored the continuity of urinary tract.


Keywords


Boari flap;Psoas hitch;iatrogenic ureteral trauma;ureteroneocystostomy;ureteric stricture;ureteral injury

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DOI: http://dx.doi.org/10.19264/hj.v30i3.240