The vesico-psoas hitch usually has been advocated for the management of lower ureteral injuries or failed ureteroneocystostomies when there is inadequate ureteral length. Since 1966 we have used this technique in 36 children with obstructed megaureters. There has been no postoperative obstruction and reflux has been prevented in all but 1 case. The vesico-psoas hitch has proved to be an important adjunct in the repair of the obstructed megaureter, since it allows the construction of a long intravesical ureter, thus avoiding reflux, and locates the new ureteral hiatus in the bladder at a fixed point so that ureteral kinking and obstruction are prevented.
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