MODIFIED PSOAS HITCH CAN REPLACE BOARI FLAP WITHOUT COMPROMISING VASCULARITY

Mirzazadeh M1, Smith W1

1. Wake Forest Baptist Medical Center Department of Urology

KEYWORDS: Retrospective Study, Surgery, Anatomy

The Boari Flap has been in the urologist’s armamentarium for tension free reconstruction of mid and proximal ureteral defects for over 70 years. However, complications can occur because of compromised blood supply due to having incisions on 3 sides of the flap, and relying on the flap base as the only source of blood supply. Rates of ureteral stricture and anastomotic leak are quoted as high as 10 to 20%. We present our technique of a modified Psoas hitch that does not compromise blood supply, and can be as effectively as a Boari Flap in bridging long ureteral defects and ureteral substitutions.

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