title: Laparoscopic Extravesical Submucosal Tunneling Ureteroneocystostomy Combined with Psoas Hitch for Medium-Length Distal Ureteral Defects in Adults.
abstract: OBJECTIVE
  This study aims to describe the technique and feasibility of laparoscopic submucosal tunneling ureteroneocystostomy in combination with psoas hitch to restore urinary tract continuity in patients showing medium-length distal ureteral defects.
  
  
  METHODS
  From January 2012 to April 2016, a total of 13 patients (4 males and 9 females) with a mean age of 37 years were performed with the laparoscopic operation of ureteral submucosal tunneling reimplantation combined with psoas hitch. The mean defective length was 5.5 cm (range 4-8 cm). The etiologies included ureteral strictures secondary to endoscopic laser lithotripsy in 2 patients, previous gynecological surgeries in 4, infiltrative ureteral endometriosis in 3, as well as ureteral strictures without obvious causes in the remaining 4.
  
  
  RESULTS
  The operations were successfully performed in all patients. The mean operating time was 179 min (range 150-230 min). The mean estimated blood loss was 32 mL (range 15-80 mL). The mean drainage time was 5.8 days (range 4-8 days). No major complications occurred during the perioperative period. The mean follow-up time was 25 months. All patients experienced symptomatic relief and showed good urine drainage.
  
  
  CONCLUSIONS
  Extravesical submucosal tunneling ureteroneocystostomy combined with psoas hitch under laparoscopy is a feasible and effective option for medium-length distal ureteral defects in selected patients.
authors.affiliation: Department of Urology, Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Beijing, PR China.
authors.forename: Huijie
authors.initials: H
authors.lastname: Gong
authors.forename: Yiqin
authors.initials: Y
authors.lastname: Lu
authors.forename: Yongji
authors.initials: Y
authors.lastname: Yan
authors.forename: Zhenqi
authors.initials: Z
authors.lastname: Wu
authors.forename: Wenfeng
authors.initials: W
authors.lastname: Gao
authors.forename: Haisheng
authors.initials: H
authors.lastname: Cheng
authors.forename: Yabing
authors.initials: Y
authors.lastname: Wu
authors.forename: Yanfeng
authors.initials: Y
authors.lastname: Li
authors.forename: Xuetao
authors.initials: X
authors.lastname: Ma
authors.forename: Jingbo
authors.initials: J
authors.lastname: Liu
authors.forename: Linfeng
authors.initials: L
authors.lastname: Dai
mesh_terms: D000328:Adult; D003559:Cystostomy / Q000379:methods*; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D061646:Operative Time; D016658:Psoas Muscles / Q000601:surgery*; D016896:Treatment Outcome; D014513:Ureter / Q000473:pathology / Q000601:surgery*; D014515:Ureteral Diseases / Q000601:surgery; D014517:Ureteral Obstruction / Q000601:surgery; D013520:Urologic Surgical Procedures