Last revised by Matt A. Morgan on 3 Jun 2016

Transureteroureterostomy (TUU) is a procedure in which one ureter is divided and then connected (re-routed) into the other. It is performed when a distal ureter needs to be bypassed and can be performed instead of a psoas hitch or Boari flap. It may be preferable if the patient has had prior radiation therapy to the pelvis or prior extensive pelvis surgery.

A TUU can be imaged effectively either with CT urography or retrograde pyelography. Intravenous urography could be used as a second line if either of these imaging modalities are not available.

The main drawback of a TUU is that in order to treat one ureter, both kidneys and ureters are potentially put at risk (e.g. a distal ureteral stone now causes hydronephrosis in both kidneys).

  • anastomotic urine leak
  • recurrent stricture

First performed in 1935 by Higgins 4.

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