After complicated gynaecologic procedures ureter can be injured and closed in the suture. In such circumstances hydronephrosis appears, which is temporary managed by nephrostomy to protect kidney and save renal function. After that, usually after 3 months, pyelography is performed and if there is still dilated pyelocalyceal system patient is qualified to surgery based on ureteral cutting at the level of ligation and neoimplantation to the baldder wall. Dependig on the tension of the neoanastomosis sometimes “psoas hitch” procedure is mandatory and bladder wall must be sutured to the psoas muscle to gain tension free anastomosis. During reconstruction double J stent is inserted into the ureter to facilitate recovery. After few days nephrostomy is removed, JJ stent is withdrawn afters 3-4 weeks and patient is able to live normal life without catethers, drains and urinary bags.
- 1 – Ureteral cystoneoimplantation with psoas hitch after complicated hysterectomy (A. Białeta, K. Lebiedziński, A. Kołodziej)
- 2 - Ureteral cystoneoimplantation with psoas hitch after complicated URSL (A. Białeta, Ł. Lizut)