Ileocecal Substitution in the Treatment of Severe Ureteroscopy-Related Ureteral Trauma: Report of Three Cases

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Abstract
Three patients with severe ureteral injuries caused by trauma from ureteroscopy were managed with ileal ureteral substitution procedures because the length of the ureteral damage made other techniques inappropriate. Renal function was preserved in all patients, and the postoperative results were gratifying. In ureteroscopic injuries, after excision of unsalvageable ureteral tissue, the defect is best bridged by careful mobilization and renal descensus (for proximal injuries) or a vesicopsons hitch with or without a Boari flap (for distal injuries). If repair is not possible with these operations and the serum creatinine is less than 2.0 mg/dl, we advocate ileoureteral substitution with an end-to-side ileo vesical anastomosis. Autotransplantation is a reliable alternative in some cases.