AVULSION OF THE UPPER URETER SECONDARY TO BLUNT TRAUMA

SUMMARY A case of avulsion of the upper ureter due to blunt trauma, successfully treated by early primary ureteral anastomosis, is presented. A review of the English literature reveals five other cases similarly treated. It is apparent from this and other reports that primary anastomosis of the avulsed upper ureter is not only feasible, but will provide superior results. Early diagnosis is necessary if renal and ureteral function are to be preserved, Delayed exploration and attempts at repair may be associated with distortion of normal anatomical relationships, fibrosis of the injured ureter, and hydronephrosis and pyelonephritis precluding any hope of restoring normal renal function. In addition, perinephric abscess or persistent urinary fistula after delayed exploration may necessitate nephrectomy. Early exploration and repair with meticulous care and fine suture material should prevent these complications in most cases. Restitution of normal renal and ureteral function may be anticipated.