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

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.