Objective: To evaluate the treatment modalities of total ureteral avulsion and to clarify the risk factors of this serious complication. Methods: This study retrospectively analyzed the data of 3 patients with complete ureteral avulsion during ureteroscopy. Of the three patients, two had distal ureteral complete avulsion, and one total ureteral avulsion on both ends. Ureteroneocystostomy (UNC) was immediately performed after distal ureteral avulsion cases. Ileal ureter substition was performed on the same session after the total ureteral avulsion in both ends. Two of the patients were under chronic use of corticosteroid treatment due to diagnosis of idiopathic trombocytopenic purpura and myastenia gravis and all patients had unsuccesful shockwave litotripsy (SWL) treatment history with at least 1 month period before surgery. Results: The patient who had ileal ureter substitution was followed at 3-month intervals by ultrasonography and renal function tests and she was uneventful after a 2 year follow-up period. The patients treated with UNC were followed up at 3 month interval by ultrasonography and renal function tests. They had normal renal function 1 year after the operation Conclusion: Complete ureteral avulsion is a rare but severe complication. Treatment modality can vary and ileal ureter can be applied succesfully in the total ureter avulsion in both ends when bladder capacity is not enough for a Boari flap. Failed SWL and/or corticosteroid treatment history of patients seems to increase the risk of the ureteral avulsion.KEY WORDS: Avulsion; Lithotripsy; Ureterorenoscopy. quency of complications varies between 0.5% and 10% in the literature (1-3). Ureteral avulsion is the most serious complication and occurs in 0-0.5% patients (4). Treating ureteral avulsion is a challenge. Patient comorbidities, the condition of the kidney, severity of the ureteral damage, and experience of the surgeon can affect the choice of treatment. In this study, we aimed to discuss our experience and possible leading factors of this serious complication in the light of the current literature. MATERIALS AND METHODSWe retrospectively analyzed three ureteral avulsion cases and treatment modalities at two referral hospitals between January 2008 and October 2014. All patients underwent rigid ureteroscopic procedures for removing ureteral stones, and ureteral avulsion occurred during the retrograde examination of the ureter. Of the three patients (1 man, 2 women; age: 28-65 years, one right, two left), the avulsed ureter was repaired during the same session of the ureterorenoscopic surgery. The ureter stones were located in the distal ureter in two patients and in the proximal ureter in one patient. All patients had unsuccessful SWL treatment and at least a 2 week interval before further investigation and treatment were applied. Two patients who have been diagnosed with idiopathic thrombocytopenic purpura and myastenia gravis received chronic corticosteroid treatment. The patients were evaluated with abdominal X-ray, ultrasonography, int...

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In this study we found that half of the children with EN had tonsillar hypertrophy, which was significantly higher than in the control group. Further studies are needed to clarify the exact relationship between UAO and EN.

The aim of this study was to describe a technique using full-thickness skin grafts (FTSGs) from different parts of the body for salvage urethroplasties and the present outcomes. A total of 24 men underwent urethroplasties for strictures averaging 7.7 cm (range, 5-17 cm) in length, using FTSGs from the inner arm, inner thigh, or abdominal skin. Each of these cases had at least one failed urethroplasty. Twenty-four patients underwent surgery for 26 urethral strictures, with a mean follow-up period of 23.2 (5-44) months and a mean operation time of 140 (115-180) minutes. Reconstruction of the urethra with skin grafting was successful in 18 out of the 26 procedures during the first attempt (69%). A "redo" skin grafting was performed for the eight failed cases, with four successful procedures (50%). Overall, the success rate was 84% (22 out of 26 urethral strictures); however, the failed cases developed abscesses and later, ureterocutaneous fistulas. No hair formation from the skin grafts was seen. Skin grafts provide useful alternative graft sources for previously failed long-segment urethral strictures in which the buccal mucosae are not available or are insufficient for salvage urethroplasties with an acceptable success rate.