EFFICIENCY AND SAFETY OF BILATERAL BOARI BLADDER FLAP

We performed a retrospective evaluation of the results of bilateral ureteral reconstruction using a tubularized bladder flap. The purpose of the study was to determine the effectiveness of bilateral Boari surgery to correct ureteral defects. The study included 8 patients who required bilateral ureteral reconstruction. Synchronous operations were performed in 4 patients, other patients (n=4) underwent two-stage operations. The effectiveness of Boari surgery was evaluated retrospectively by analyzing complications and long-term treatment outcomes. The length of the bladder flap on the right varied from 6 to 15 cm and averaged 10.0 ± 3.5 cm, on the left it was from 7 to 13 cm with an average value of 9.3 ± 2.3 cm. The total frequency of intraoperative complications did not exceed 25.0%. Postoperative complications were observed in 5 (62.5%) patients (grade I or II according to Clavien-Dindo). The most common problem was exacerbation of pyelonephritis and leakage of urine from a postoperative wound. Severe dysuria was found in only 2 (25%) patients. A decrease in bladder capacity with persistent hyperactivity was recorded 2 months after surgery in one case. Chronic urinary retention was also observed in one patient. The total number of positive long-term results (good + satisfactory result) was 75%. Two negative results were recorded in patients after synchronous bilateral operations. Boari surgery is an effective and safe method of ureteral reconstruction for defects of both ureters. Two-stage operations have priorities over synchronous bilateral reconstruction due to a higher level of positive long-term results.