Ventriculoureteral Shunt Operation for Treatment of Recurrent Abdominal Pseudocyst Complicating Ventriculoperitoneal Shunt: Case Report and Technical Note

We report a case of ventriculoureteral shunt to reise malfunctioning ventriculoperitoneal shunt in a 30-year-old man. The patient had 4 times recurrent pseudocyst filled with cerebrospinal fluid caused by complications at the distal end of the abdominal catheter. The presence of an abdominal pseudocyst can be detected by performing an ultrasound examination of the abdomen. We shall describe the operative technique of the ventriculoureteral shunt procedure without nephrectomy by reimplantation of the ureter and a psoas hitch.

Psoas Hitch Ureteroneocystostomy / 대한비뇨기과학회지

The Psoas hitch procedure is a universal approach for ureteral reimplantation in all diseases of the distal ureter. Digital ureteral defect due to iatrogenic lesion and chronic inflammation such as tuberculosis, congenital ureteral anomalies including complicated reflux in child are the main indications for the Psoas hitch plasty. We performed ureteroneocystostomy with Psoas hitch procedure in l4 patients in recent 3 years. We evaluate the preoperative state. operative technique, postoperative course and follow-up of these cases and report with the review of the articles. The results were as follows: l. Fourteen cases included 7 ureteral injuries by 3 cases of transabdominal hysterectomy and 4 cases of ureterolithotomy, 3 chronic inflammatory stricture ie. tuberculosis, 2 traffic accidents, l bladder CA. in bladder diverticulum, 1 con genital megaureter. 2. Psoas hitch ureteroneocystostomy was done by submucosal tunnel with Psoas hitch in 9, end to side with Psoas hitch in 3, submucosal tunnel with Psoas hitch and Boari flap in 2 cases. 3. There were improvements in all l4 cases without ureterovesical stenosis or VUR. And functional capacity of the bladder has been well preserved. Postoperative complications were UTI in 3 cases.

Experiences of the Vesico-Psoas Hitch Procedure for Extensive Lower Ureteral Stricture / 대한비뇨기과학회지

Three patients have successfully undergone ureteroneoystostomy with submucosal tunneling as an antirefluxing measure using vesico-psoas hitch procedure for extensive postoperative stricture of the lower ureter. Postoperatively, none of the patients has developed ureterovesical stenosis, and functional capacity of the bladder has been well preserved despite of extensive mobilization. In one patient reflux has occurred through the ureteral orifice of the opposite side. Since the technique of vesico-psoas hitch procedure is simply to mobilize the bladder and to fix its posterolateral corner to the psoas muscle, we believe that it provides a safer alternative to more complicated and potentially dangerous procedures.