del2288

When distal ureteral avulsion is noted, ureteroneocystostomy repair can be performed, with a psoas bladder hitch if necessary to create a tension-free anastomosis. A Boari bladder wall flap will increase the proximal extent of the repair to the middle third of the ureter. These repairs are performed most commonly over a ureteral catheter with perianastomotic drainage. This can be performed acutely at the time of the injury or in a staged fashion after proximal percutaneous drainage is obtained at the time of the injury.