Boari flap with hydronephrosis

Case contributed by Ian Bickle
Diagnosis certain


Previous bladder surgery. Left-sided hydronephrosis on follow-up imaging.

Patient Data

Age: 65 years
Gender: Male

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.

Case Discussion

A Boari flap is a urological procedure undertaken reimplant the ureter by replacing the distal ureter ureter when this has been destroyed or damaged ( tumor 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.

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