• Jiang Fuquan, Zhang Gang, Xiao Jianlin, and Ruofeng Yin.
• Department of urinary surgery.
• Medicine (Baltimore). 2020 Aug 14; 99 (33): e21727e21727.

IntroductionReports pertaining to ureteral injury sustained during lumbar disc surgery are rare; most ureteral injuries in this setting involve laceration or transection.Patient ConcernsWe 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.DiagnosisThe 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.InterventionWe used a spiral bladder muscle flap with vascular pedicles to repair the ureteral defect.OutcomesPost-operative period was uneventful and the patient showed good recovery.ConclusionSpiral bladder muscle flap with vascular pedicles may be used to repair extensive ureteric injury.

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