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Ureteric Injuries And Boari Flap

Ureter can be injured many times either during accident or may be iatrogenic while performing spine surgery, hysterectomy, cesarean section etc, diagnosis is made on table in case of when done by doctor and in other case it is done by intravenous pyelography, CECT abdomen, Retrograde and antegrade pyelogram. Patient should be open with in 3 days but never after 7 days, You can have long Boari reaching upto pelvis, general boari of about 10 cm and yes it can be made bilaterally. Give incision on bladder, make a flap, insert ureter after spilliting flap, make a opening and stitch ureter, now make a roll of flap to form tube like structure, some times it need support so we make a psoach hitch. You can see how ureter injury looks like in retrograde pyelogram here    • Retrograde Pyelography Showing Ureter injury