MANAGEMENT OF COMPLETE URETERAL REPLACEMENT - EXPERIENCES AND REVIEW OF THE LITERATURE

The common treatment for patients with extensive damage to the ureter is complete ureteral replacement, combining Boari flap-psoas bladder h itch and downward mobilization of the involved kidney, with complete i deal replacement of the ureter, renal autotransplantation, or elective nephrectomy. Three case reports serve to describe two options of reco nstructive treatment for complete ureteral replacement. The operative techniques, their limits, their postoperative results, and the treatme nt alternatives are discussed with due regard to recent literature. In the case of ileal replacement we have used a very short ileal segment to reduce the absorption surface of the ileal mucosa. Reflux preventi on of the ileal segment was performed by creating an invaginated dista l ileum nipple which was additionally fixed at the Boari flap by a thi rd stapler row (auto suture TASS) to prevent potential nipple-gliding.