Boari flap with hydronephrosis
Previous bladder surgery. Left sided hydronephrosis on follow-up imaging.
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The left side of the dome of the bladder is hitched up, being contiguous with the distal ureter.
The left renal collecting system and ureter are dilated in keeping with severe hydronephrosis.
A Boari flap is a urological procedure undertaken reimplant the ureter by replacing the distal ureter ureter when this has been destroyed or damaged ( tumour invasion, stricture ). A tube of bladder tissue is used, being 'pulled''up rather like a ear or the top of a tent, giving a characteristic appearance to the bladder.
In this case a Boari flap has been performed, but the patient has gone on to develop a severe hydronephrosis, from a presumed new stricture.