High Ureteral Injuries

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Abstract
Autotransplantation of the kidney provides a means of preserving renal function without nephrostomy when high ureteral injury cannot otherwise be corrected. A case is reported in which the right ureter, placed behind an aortic prothesis 6 yr earlier, was unwittingly severed during resection of a large aneurysmal homograft with insertion of a Teflon bifurcation replacement. The ureteroureteral anastomosis became strictured. The left kidney was hydronephrotic and right nephrostomy was associated with repeated infection. The right kidney was successfully transplanted to the right iliac fossa, the renal artery being anastomosed to the external iliac artery and the renal vein to the external iliac vein. The ureteral segment was readily implanted into the bladder. Postoperative studies revealed increasingly efficient function of the autotransplanted kidney as reflected by indigo carmine excretion, renal scanograms, and excretory urogram.

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