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[Appendicouretheroplasty]
Abstract:
Repair of long uretheral defects with the appendix (appendi-couretheroplasty--AUP) was made in 5 patients. Stenosis of the lumbar urether was caused by a gunshot wound in one patient. Uretheral strictures developed after iatrogenic injury during extended gynecological operations in 3 women. The strictures arose after radiotherapy in one female. The man has undergone plastic reconstruction of the upper third of the right ureter, while women - replacement of the pelvic urether, including one case on the left. In two cases a modified surgical technique was used for better appendicocystanastomosis--a flap was dissected from the cupola of the cecum. In one case surgery was combined with simultaneous contralateral Boari's operation, in the other case--with transvaginal suturing of the vesicovaginal fistula. Exacerbation of chronic pyelonephritis occurred in one patient. In the other case antegrade pyeloureterography has detected stricture of ureteroappendicoanastomosis. Resection of the stricted place and reanastomosing were performed in this patient. Passability of the urinary tract recovered in all the patients. Thus, replacement of any part of the right and pelvic part of the left ureter with the appendix is feasible with good results.
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