We have reported the late results of ureteroplasties following gynecological operations in 91 patients. In all the 91 cases the ureteral defect was closed with a bladder flap by the Boari technique. In eleven cases the operation failed to be successful. Ten of these unsuccessful cases were patients with carcinoma. Analysis of the failures and the strict application of a modified surgical technique according to the procedure described by GIL-VERNET, with submucosal, displacement of the ureter as an antireflux protection, greatly improved our late results. On the basis of two case histories we have demonstrated the problem of postoperative radiotherapy in patients with carcinoma in whom ureteroplasty is necessary following intra- and post-operative ureteral lesions. Replacement of the distal ureter by a Boari flap over a length of more than 12 cm is possible in particular cases. Bilateral ureteral lesions, especially in patients with carcinoma, are operated most successfully by the transperitoneal approach. We also recommend the transperitoneal approach in patients who have undergone radiotherapy and in those with repeated Boari plasties.

Keywords:
Ureteroplasty by the bladder flap technique, Antireflux principle, Tension free anastomosis, Postoperative radiotherapy, Transitory nephrostomie, High ureteroplasty, Bilateral ureteroplasty, Transperitoneal approach
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© 1972 S. Karger AG, Basel
1972
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