Complete ureteral necrosis after injury sustained during lumbar disc surgery

Introduction Reports pertaining to ureteral injury sustained during lumbar disc surgery are rare; most ureteral injuries in this setting involve laceration or transection. Patient concerns We report a rare case of a 55-year-old man who presented with complete left ureteral necrosis 20 days after sustaining ureteral transection during lumbar disc surgery. Diagnosis The patient presented with seroperitoneum caused by left ureteral injury; post-operative histopathological examination of surgical specimen after discectomy had revealed ureter-like tissue. Exploratory laparoscopic surgery revealed necrosis of a long segment of ureter, which was not amenable to treatment with conventional methods. Intervention We used a spiral bladder muscle flap with vascular pedicles to repair the ureteral defect. Outcomes Post-operative period was uneventful and the patient showed good recovery. Conclusion Spiral bladder muscle flap with vascular pedicles may be used to repair extensive ureteric injury.