[Plastic surgery in stenoses and intraoperative injuries of the urinary tract]

The author showed the practical significance and expediency of performing reconstructive-plastic operations (57 patients) in surgical correction of severe pathology of the urinary tract. The indications for plastic operations were stenoses of various etiology, intraoperative traumas of the urinary tract, contracted bladder and the consequent ureterohydronephrosis, renal insufficiency. The choice of the tactics and method of surgical treatment should be strictly substantiated and based on the individual features of the urinary system pathology, the character of the intraoperative trauma of the ureter and bladder and its possible after-effect on the kidney. Taking into account the variability of the pathology and the length of the cicatricial narrowing of the pelvic-ureteral segment and ureter, and the degree of kidney constriction, variations of plastic operations differing in the complexity of the techniques were applied. These were small in volume flap plastics of the pelvic-ureteral segment and ureter (Calp-de-Virda, Baori, Demela) and intestinal plastics of the bladder in one of the modifications. The possibility of plastic operations in restoration of physiological urination and social rehabilitation of patients with urinary fistulas was determined. According to early and late-term postoperative follow-up, the results of the operation were favorable in 91.3% of cases. Postoperative mortality in different periods (7 days to 3 years) was 8.7%.