Reconstruction of extensive upper ureteral damage.

Abstract

Injuries of the ureter are associated with serious surgical complications. Injury to the lumbar (upper) part of the ureter is rare, and reconstruction may pose considerable surgical challenges. A technique is described that proved useful reconstruction of upper ureteral damage. Reconstruction surgery for a ureterocutaneous fistula was required as a result of earlier removal of a retroperitoneal tumor. The Heineke-Mikulicz maneuver was used to bridge a gap between the ureteral edges. Ureteral continuity was achieved and the need for other more morbid measures was avoided. This maneuver is recommended for ureteral reconstruction as a valid additional technique in the urological armamentarium.