ABSTRACT
BACKGROUND: Any large missing part of the ureter may be replaced by transureteroureterostomy, psoas hitch, Boari flap, nephrectomy, renal autotransplanation or by the implementation of an intestinal graft. CASE REPORT: A patient with a defect of the lumbal-pelvic portion of the right ureter, after the managemenet of a penetrating and perforating gun shot wound was presented. The missing part of the ureter was seccessfully replaced with an appendix. The technique of uretero-transappendix-cystoneostomy complete with a Boari flap and a psoas hitch was used. CONCLUSION: By the use of an original combination of surgical techniques, a large defect of the ureter and the defect of the bladder, as well as the preservation of the renal function was achieved in a more successful manner.