Surgical Repair

Of utmost importance is accurate determination of the length and level of defect to be repaired, which can be done by a combination of the aforementioned radiologic studies. The upper ureter and ureteropelvic junction can be accessed via either a flank approach or through a dorsal lumbotomy incision. Extraperitoneal access to the middle and distal ureter is best obtained with a Gibson incision. Although the incision can be extended medially to expose the bladder, we prefer to use a midline incision.

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