1. (A–C) Right ureteral reimplantation following extensive distal ureteral injury. Prior bladder surgery or pelvic inflammatory or neoplastic disease, among other factors, may make psoas hitch or bladder flap repair undesirable. The injured ureter is mobilized, spatulated and reimplanted to the bladder Boari flap/psoas hitch with tension-free and water-tight anastomosis. Omental wrap should be considered to decrease chances of fistulization or urine extravasation. (A) Intraoperative depiction of Boari flap/psoas hitch and ureteral reimplantation after right distal ureteral avulsion due to a gunshot wound to the abdomen and pelvis (pink shadow represents the bladder flap secure with psoas hitch and the yellow shadow represents the ureter). (B) Coronal view of CT cystogram 14 days after ureteral repair. (C) VCUG performed 6 months post-Boari flap/psoas hitch and ureteral reimplantation after right distal ureteral injury during abdominal hysterectomy.
Source: Genitourinary Trauma, Trauma, 8e
Citation: Moore EE, Feliciano DV, Mattox KL. Trauma, 8e; 2017 Available at: Accessed: November 15, 2017
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