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Ureteric substitution with Boari bladder flap.

H G Motiwala¹, S A Shah, S M Patel

¹Department of Urology and Transplantation, B.J. Medical College, Ahmedabad, India.

British Journal of Urology

|October 1, 1990

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Boari bladder flap surgery successfully reconstructed ureteric injuries in 12 patients. This ureteric substitution technique, utilizing a double J stent, demonstrated excellent outcomes with minimal complications, highlighting its efficacy in complex cases.

Area of Science:

Urology
Surgical Techniques
Reconstructive Surgery

Background:

Ureteric injuries present complex reconstructive challenges.
Previous surgical interventions and conditions like tuberculosis can lead to ureteric strictures and fistulas.
Management of ureteric defects requires innovative surgical solutions.

Purpose of the Study:

To evaluate the efficacy and outcomes of ureteric substitution using a Boari bladder flap.
To assess the feasibility of this technique in patients with diverse ureteric pathologies.
To identify key factors contributing to successful ureteric reconstruction.

Main Methods:

A retrospective review of 12 patients undergoing ureteric substitution with a Boari bladder flap between 1986 and 1989.

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Indications included iatrogenic ureteric injury, strictures, fistulas, and other complex conditions.

Eleven patients received Double J stenting post-operatively.

Main Results:

Successful reconstruction was achieved in 11 out of 12 patients, with no mortality or significant morbidity.
The single complication involved stent migration requiring surgical removal.
Key factors for success included tension-free anastomosis, a well-vascularized flap, Double J stenting, and vicryl sutures.

Conclusions:

The Boari bladder flap is a safe and effective method for ureteric substitution in managing complex ureteric injuries and strictures.
Meticulous surgical technique, including proper flap design and stenting, is crucial for optimal outcomes.
This reconstructive approach offers a viable solution for challenging urological conditions.