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The vesico-psoas hitch as an adjunct to megaureter repair in childhood
Insights
The vesico-psoas hitch is effective for treating obstructed megaureters in children. This surgical technique prevents obstruction and avoids reflux, offering a reliable solution for ureteral repair.
Area of Science:
- Urology
- Pediatric Surgery
Background:
- The vesico-psoas hitch is a surgical technique.
- It is used for lower ureteral injuries or failed ureteroneocystotomies with inadequate ureteral length.
Purpose of the Study:
- To evaluate the efficacy of the vesico-psoas hitch in managing obstructed megaureters in children.
Main Methods:
- The vesico-psoas hitch technique was employed in 36 children with obstructed megaureters since 1966.
Main Results:
- No postoperative obstruction was observed.
- Reflux was prevented in all but one case.
Conclusions:
- The vesico-psoas hitch is a valuable adjunct for obstructed megaureter repair.
- It facilitates the creation of a long intravesical ureter, preventing reflux.
- It secures the ureteral hiatus, preventing kinking and obstruction.
Abstract:
The vesico-psoas hitch usually has been advocated for the management of lower ureteral injuries or failed ureteroneocystostomies when there is inadequate ureteral length. Since 1966 we have used this technique in 36 children with obstructed megaureters. There has been no postoperative obstruction and reflux has been prevented in all but 1 case. The vesico-psoas hitch has proved to be an important adjunct in the repair of the obstructed megaureter, since it allows the construction of a long intravesical ureter, thus avoiding reflux, and locates the new ureteral hiatus in the bladder at a fixed point so that ureteral kinking and obstruction are prevented.