title: Ureteric substitution with Boari bladder flap.
abstract: Between 1986 and 1989, 12 patients underwent ureteric substitution with a Boari bladder flap at this Institute. The indications were ureteric injury following hysterectomy, difficult forceps delivery, difficult ureterolithotomy, ureteric strictures caused by a Dormia basket and previous ureteric surgery, tuberculosis, retroperitoneal fibrosis and a post-ureteric reimplantation fistula. There were 2 patients with a solitary kidney and 2 in acute renal failure. Double J stenting was carried out in 11 patients and the stent was removed 3 to 6 weeks post-operatively. Good results, with no morbidity or mortality, were achieved in all but 1 patient where a simple Silastic stent had migrated to the pelvis and required open surgery to remove it. We attribute our success to the tension-free anastomosis, a wide based posterior flap with preservation of its vascular supply, the use of a double J stent and vicryl suture material.
authors.affiliation: Department of Urology and Transplantation, B.J. Medical College, Ahmedabad, India.
authors.forename: H G
authors.initials: HG
authors.lastname: Motiwala
authors.forename: S A
authors.initials: SA
authors.lastname: Shah
authors.forename: S M
authors.initials: SM
authors.lastname: Patel
mesh_terms: D000293:Adolescent; D000328:Adult; D000714:Anastomosis, Surgical; D005260:Female; D005548:Foreign-Body Migration / Q000150:complications; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography; D015607:Stents; D013524:Surgical Flaps / Q000379:methods*; D014513:Ureter / Q000000981:diagnostic imaging / Q000293:injuries / Q000601:surgery*; D001743:Urinary Bladder / Q000601:surgery*