Management of complete ureteral avulsion and literature review: a report on four cases.
OBJECTIVE
The aim of this study was to investigate the treatment modality of complete ureteral avulsion.


METHODS
This study retrospectively analyzed the data of four patients with complete ureteral avulsion who were treated between November 2003 and March 2008 in our hospital. Of the four patients, one had ureteropelvic junction avulsion, one had proximal ureteral avulsion, and the other two had distal ureteral avulsion. One patient underwent autotransplantation of kidney for treatment of severe proximal ureteral avulsion. Pyeloureterostomy plus greater omentum investment outside the native distal ipsilateral ureter was performed in the patient with ureteropelvic junction avulsion. The other two patients underwent ureterovesical anastomosis. All four patients were followed up for an average time of 29 months (16-45 months).


RESULTS
Renal function recovered well in the patient who underwent autotransplantation of kidney and ureterovesical anastomosis and the two patients who underwent ureterovesical anastomosis. The other patient who underwent pyeloureterostomy developed hydronephrosis and nonfunctioning kidney. The patient then underwent nephrectomy.


CONCLUSIONS
Complete ureteral avulsion is a rare but severe complication. Autotransplantation of kidney and ureterovesical anastomosis may result in positive outcomes in patients with proximal ureteral avulsion.
Department of Urology, Institute of Surgery Research, Daping Hospital, The Third Military Medical University, Chongqing, China.
Chengguo
C
Ge
Qiansheng
Q
Li
Luofu
L
Wang
Fengshuo
F
Jin
Yanfeng
Y
Li
Jianghua
J
Wan
Weihua
W
Lan
Peihei
P
Liang
D000328:Adult; D003710:Demography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019990:Perioperative Care; D014513:Ureter / Q000002:abnormalities* / Q000601:surgery*