Operation Boari. Prices, reviews, ratings
General information
The Boari operation is a plastic surgical intervention that is performed to reconstruct the lower ureter.
The Boari operation is performed only when the pelvic section of the ureter has been damaged.
The process of the operation
Preparation
Immediately before the surgery, each patient must take blood and urine tests.
The process of the Boari operation
This type of surgical intervention has several stages:
- removal of the ureter;
- cutting a flap from the bladder;
- formation of an artificial part of the ureter;
- formation of a ureteral-vesical junction (anastomosis).
During the operation, the patient lies on his back. A catheter is inserted. The incision is made in the lower abdomen. After the peritoneum and spermatic cord are displaced, the ureter is isolated using a rubber holder.
After this, the urologist surgeon removes the bladder using special clamps and, after cutting some connecting parts, pulls it to the incision. Then, a flap 2-2.5 cm wide and 10-12 cm long is cut out from the front or side surface.
The cut stem is sutured in the form of a tube, which is attached to the ureter (the diameter of the tube should exceed the diameter of the ureter). In this case, the bladder itself is sutured with the end of its catheter brought out through the urethra. The catheter itself is removed on the 7th-10th day after the operation.
If the pelvic ureteral section is completely damaged, then surgery is performed using the Demel method. In this case, the bladder is opened on the side opposite the defective ureter. By cutting the bladder obliquely, from the front and back, the doctor makes a wide flap, half the size of the bladder, from which he also forms a stem and, having stitched its edges, inserts the ureter into it.
Rehabilitation period
Rehabilitation usually involves infusion, antibacterial and anti-inflammatory therapy. Then a control ultrasound diagnosis and retrograde urethrography are performed.
Indications
The Boari operation is performed only when the pelvic part of the ureter has been damaged.
Contraindications
The Boari operation is strictly contraindicated in cases of a shrunken bladder and destruction of the distal part of the ureter.
Complications
If the patient has pain or subfebrile temperature, then an ultrasound diagnosis or urography is necessary. Such symptoms may indicate damage to the second ureter. If an infectious inflammation of the urinary tract develops, the patient is prescribed antibacterial drugs.
If the inflammation does not go away, which indicates resistance to the connection formed during the operation, ultrasound diagnostics and nephrostomy are performed.
Prices and clinics
Considering the complexity and the possibility of serious consequences, the Boari operation is not performed in all clinics. In order to find a list of clinics, you can use the medical portal .
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