Routine Use of the Psoas Hitch in Ureteral Reimplantation

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Abstract
Previously, the psoas hitch had been advocated only for difficult cases of ureteral reimplantation, especially when there had been inadequate ureteral length. During the last 10 yr the psoas hitch in association with a modified Paquin technique was used routinely for ureteral reimplantation. The technique was used in all unilateral cases and in most bilateral reimplants. Results have been excellent. The psoas hitch allows for a long submucosal tunnel, with a fixed relationship between the ureter and posterolateral bladder wall. Intermittent hydronephrosis is not seen with this method of reimplantation and there have been no voiding disturbances.