Successful treatment of upper ureteral injury using renal autotransplantation.
BACKGROUND
Ureteral injuries are uncommon. Upper ureteral defect more than 7-8 cm in length is a challenge for urologists, requiring experience and several steps in its management. We report a case of iatrogenic upper urinary tract injury and successful treatment of 8-cm ureteral defect using autotransplantation of the kidney.


METHODS
A male patient underwent surgery due to retroperitoneal tumor. Iatrogenic ureteral injury was recognized 18 days after operation. Three-step management of urinary tract injury was performed. The first step included minimally invasive recovery of the urine flow and treatment of infection. The second step was unsuccessful renal descensus and new formation ureteropyeloanastomosis because of difficulties of kidney mobilization caused by previous surgery. The third step included a successful autotransplantation of the kidney and complete reconstruction of the urinary tract.


CONCLUSIONS
Autotransplantation can be successfully used for the management of long upper ureteral injury in referral urological centers.
Milonas
Daimantas
D
Department of Urology, Kaunas University of Medicine, Eiveniu 2, 50009 Kaunas, Lithuania. daimantasmilonas@yahoo.com
Stirbys
Saulius
S
Jievaltas
Mindaugas
M
D005500:Follow-Up Studies; D006801:Humans; D006869:Hydronephrosis / Q000000981:diagnostic imaging / Q000209:etiology; D007049:Iatrogenic Disease; D007431:Intraoperative Complications; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D009403:Nephrostomy, Percutaneous; D012017:Referral and Consultation; D012186:Retroperitoneal Neoplasms / Q000601:surgery*; D013997:Time Factors; D014182:Transplantation, Autologous; D016896:Treatment Outcome; D014513:Ureter / Q000293:injuries*; D014567:Urography