Unusual complications of transvesical ureteral reimplantation

Four of 8 cases that represent unusual and infrequent complications of the transvesicle Politano-Leadbetter ureteral reimplantation technique are reported. Approximately 90 per cent of ureteral reimplantations for vesicoureteral reflux may be done satisfactorily as a transvesical procedure but combining it with an extravesical approach of the ureter when necessary or indicated will serve to correct any conceivable congenital, acquired or iatrogenic lesion of the lower ureteral segment. The extravesical approach should be used if there is any difficulty in performing the procedure transvesically or if the patient has undergone previous attempts at antireflux operation. Obstructive complications may occur in either the early or late postoperative period. When discovered, surgical correction is usually indicated. We strongly advocate strict adherence to the surgical technique involved and meticulous postoperative followup of these patients.