Routine use of the psoas hitch in ureteral reimplantation

Previously, the psoas hitch had been advocated only for difficult cases of ureteral implantation, especially when there had been inadequate ureteral length. However, during the last 10 years the paoas hitch in association with a modified Paquin technique has been used routinely at this institution for ureteral reimplantation. The technique has been used in all unilateral cases and in most bilateral reimplants. Results have been excellent. The psoas hitch allows for a long submucosal tunnel, with a fixed relationship between the ureter and posterolateral bladder wall. Intermittent hydronephrosis is not seen with this method of reimplantation and there have been no voiding disturbances.