The use of an extended spiral bladder flap for treatment of upper ureteral loss.

Abstract

We demonstrated the effectiveness of an extended spiral bladder flap procedure for repair of upper ureteral injuries. Two patients with extensive ureteral loss underwent repair with a modified bladder flap based posterolaterally on the affected side, spiraled anteriorly and inferolaterally toward the contralateral bladder base, and then anastomosed directly to the renal pelvis. With this technique renal function was preserved in both patients without obstruction on followup radiographs. Using this extended bladder flap technique a well vascularized urothelial repair can be achieved for upper ureteral injury in select patients.