Psoas-bladder hitch procedure: our experience with repair of the injured ureter in men.

Nine patients with injury to the pelvic portion of the ureter successfully underwent the psoas-bladder hitch procedure and tunnelization as an antireflux measure. Of these 9 patients 1 had a Boari bladder wall flap next to the hitch procedure to further elongate the posterolateral corner of the bladder and to bridge a ureteral defect more than 5 cm. Postoperatively, 2 patients had ureteral reflux on the side of repair and 1 had reflux on the opposite side, which was caused by excision of the bladder tumor and damage of the muscle layers backing the undamaged ureter.