Ureteral Reconstruction and Bypass: Experience with Ileal Interposition, The Boari Flap-Psoas Hitch and Renal Autotransplantation

1990 ◽  
Vol 143 (1) ◽  
pp. 20-23 ◽  
Author(s):  
Mitchell C. Benson ◽  
Kenneth S. Ring ◽  
Carl A. Olsson
Keyword(s):  
Ileal Interposition ◽  
Boari Flap ◽  
Ureteral Reconstruction ◽  
Renal Autotransplantation ◽  
Psoas Hitch

Management of Ureteral Strictures and Ureteropelvic Junction Obstruction

2019 ◽  
Author(s):  
Sean McAdams ◽  
Haidar Abdul-Muhsin ◽  
Mitchell R. Humphreys
Keyword(s):  
Ureteropelvic Junction Obstruction ◽  
Ureteropelvic Junction ◽  
Ureteral Stricture ◽  
Boari Flap ◽  
Ureteral Reconstruction ◽  
Urinary Drainage ◽  
Preserve Renal Function ◽  
Psoas Hitch ◽  
Invasive Management

The goals for management of ureteropelvic junction obstruction (UPJO) and ureteral stricture are to resolve obstruction, restore continuity, and preserve renal function while minimizing morbidity. The management of UPJO can be challenging and represents a spectrum of options that vary in the invasiveness and effective. These options include observation, long-term internal or external urinary drainage, and endoscopic or minimally invasive management. Mismanagement can potentially results in deterioration of loss of kidney function. This chapter discusses the foundations for successful management of UPJO and ureteral strictures. It also highlights the special clinical situations related to this disease entity and discusses the key advances in the field. This review contains 8 figures, 4 tables, and 73 references. Key Words: Boari flap, dismembered pyeloplasty, endopyelotomy, psoas hitch, pyeloplasty, ureteropelvic junction obstruction, ureteral obstruction, ureteral reconstruction, ureteral stricture, uretero-ureterostomy

Upper urinary tract reconstruction

2017 ◽  
Author(s):  
Anthony R. Mundy ◽  
Daniela E. Andrich
Keyword(s):  
Upper Urinary Tract ◽  
Stricture Formation ◽  
Ureteric Obstruction ◽  
Pelvic Brim ◽  
Distal Ureter ◽  
Boari Flap ◽  
Renal Autotransplantation ◽  
Urinary Tract Reconstruction ◽  
Psoas Hitch ◽  
The Common

This chapter addresses the problem of dealing with a ruptured, ligated or transected ureter, or a ureteric defect caused accidentally or intentionally by surgery. Ureteric strictures may occur as a result of tuberculosis or schistosomiasis. Tuberculous strictures may occur at either end of the ureter; schistosomal strictures occur primarily in the distal ureter. Ureteric stones are another cause of stricture formation and these tend to occur at the common sites of impaction of a stone; therefore, particularly just above the pelvic brim and just outside the bladder. It also develops the theme known as ‘bridging the gap’ and describes the techniques of ureteroureterostomy; the psoas hitch and Boari flap with ureteric reimplantation; transureteroureterostomy (TUU); and the ileal ureter; and briefly refers to renal autotransplantation. Finally, we introduce the concept of ‘complexity’ by reference to the problems of the patient with ureteric obstruction because of, or otherwise associated with radiotherapy.

scholarly journals Surgical management in retroperitoneal fibrosis: beyond ureterolysis

2021 ◽  
Vol 27 (1) ◽  
Author(s):  
Vigneswara Srinivasan Sockkalingam Venkatachalapathy ◽  
Datson George Palathullil ◽  
Dempsey Mohan Sam ◽  
George Palathullil Abraham
Keyword(s):  
Retroperitoneal Fibrosis ◽  
Young Male ◽  
Renal Unit ◽  
Disease Extent ◽  
Reconstructive Procedures ◽  
Case Presentation ◽  
Boari Flap ◽  
Ureteral Reconstruction ◽  
Minimally Invasive Surgical ◽  
Renal Autotransplantation

Abstract Background Retroperitoneal fibrosis can be associated with bilateral dense and extensive periureteral adhesions. When ureterolysis could not be successfully performed due to disease extent and severity, elaborate ureteral reconstructive procedures will be required. Case presentation A young male with retroperitoneal fibrosis presented with bilateral hydroureteronephrosis. The ureteral involvement was extensive and adhesions were dense. He was managed by laparoscopic boari flap ureteroneocystostomy on one renal unit and laparoscopic nephrectomy with renal autotransplantation on the other renal unit. Conclusions Ureterolysis is not feasible in all cases of retroperitoneal fibrosis. Extensive bilateral ureteral reconstruction without using intestinal segments is feasible. Minimally invasive surgical reconstructive procedures can be successfully employed in such scenarios also.

Repair of upper ureteric obstruction with Boari flap and psoas hitch

Urology ◽  
1986 ◽  
Vol 27 (5) ◽  
pp. 451-453 ◽  
Author(s):  
Soman Bhattacharya ◽  
Sheila Overton ◽  
Ron Yang ◽  
Shlomo Raz
Keyword(s):  
Ureteric Obstruction ◽  
Boari Flap ◽  
Psoas Hitch

scholarly journals Uretero-transappendix-cystoneostomy as a technique for the reconstruction of the lower part of the ureter

2005 ◽  
Vol 62 (12) ◽  
pp. 931-933
Author(s):  
Novak Milovic ◽  
Pero Janjic ◽  
Vladimir Bancevic ◽  
Srdjan Kupresanin
Keyword(s):  
Renal Function ◽  
Case Report ◽  
Surgical Techniques ◽  
Large Defect ◽  
Boari Flap ◽  
Gun Shot ◽  
Psoas Hitch ◽  
The Right

Background. Any large missing part of the ureter may be replaced by transureteroureterostomy, psoas hitch, Boari flap, nephrectomy, renal autotransplanation or by the implementation of an intestinal graft. Case report. A patient with a defect of the lumbal- pelvic portion of the right ureter, after the management of a penetrating and perforating gun shot wound was presented. The missing part of the ureter was successfully replaced with an appendix. The technique of uretero-transappendixcystoneostomy complete with a Boari flap and a psoas hitch was used. Conclusion. By the use of an original combination of surgical techniques, a large defect of the ureter and the defect of the bladder, as well as the preservation of the renal function was achieved in a more successful manner.

Urinary Tract Endometriosis

2009 ◽  
Vol 1 (2) ◽  
pp. 72-78 ◽  
Author(s):  
Peter Rehder ◽  
Bernhard Glodny ◽  
Renate Pichler ◽  
Andrea Kerschbaumer ◽  
Michael Mitterberger
Keyword(s):  
Urinary Tract ◽  
Ureteral Obstruction ◽  
Genetic Disorder ◽  
Large Area ◽  
Distal Ureter ◽  
Small Areas ◽  
Boari Flap ◽  
Bladder Endometriosis ◽  
Psoas Hitch ◽  
Symptoms And Signs

Endometriosis is a multifactorial polygenic genetic disorder that affects 10–20% of women. The urinary tract is affected in only 1–5% of cases and here most commonly the urinary bladder. Diagnosis of urinary tract endometriosis is made late due to its commonly asymptomatic course. The management of urinary tract endometriosis depends on the severity of the symptoms and signs, the extent of the disease, its location and the presence of renal damage because of ureteral obstruction. A conservative medical treatment is recommended for small areas of endometriosis in the bladder. For urinary tract endometriosis covering a large area, or where infiltration causes architectural damage, surgery is recommended. Partial cystectomy should be considered because of the transmural nature of bladder endometriosis. In cases of ureteral endometriosis, the surgical technique is determined by the location and extent of the lesion. For the distal ureter an ureterocystoneostomy using the Psoas hitch or Boari flap is recommended. For short, proximal ureteral involvement an end-to-end anastomosis or endoscopic incision may be used, and for extended areas, ileum interposition or kidney mobilization using nephropexy. A multidisciplinary approach is strongly recommended. Endometriosis with urological involvement more often needs surgical treatment, especially when ureteral obstruction leads to progressive kidney damage.

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