The Vesico-Psoas Hitch as an Adjunct to Megaureter Repair in Childhood

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Abstract
The vesico-psoas hitch was usually advocated for the management of lower ureteral injuries or failed ureteroneocystostomies when there is inadequate ureteral length. Since 1966 this technique was used in 36 children with obstructed megaureters. There was no postoperative obstruction and reflux was prevented in all but 1 case. The vesico-psoas hitch proved to be an important adjunct in the repair of the obstructed megaureter; it allows the construction of a long intravesical ureter, thus avoiding reflux, and locates the new ureteral hiatus in the bladder at a fixed point so that ureteral kinking and obstruction are prevented.