PMC3716246_01
Preoperative intravenous urogram
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F1
Abdominal ultrasound scan and intravenous urogram [Figure 1 which were done at the referral hospital showed bilateral hydronephrosis and strictures of distal 3/4 of left and distal 1/2 of right ureters, respectively, the urinary bladder was normal no calcification.
Three segments of intestinal ileum on its mesentery
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F2
A 5-cm segment of ileum was isolated on its pedicle and then divided into three equal parts [Figure 2].
Segments of intestinal ileum lengthened for left ureteric substitution
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F3
The middle segment was spatulated at the antimesenteric border and, proximal and distal segments were opened very close to their antimesenteric borders, respectively [Figure 3].
Use of appendix as distal right ureteric substitution
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F4
The appendix was amputated on its pedicle and its tip excised [Figure 4].
Substituted distal ureters left and right
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F5
The stents from both substituted ureters [Figure 5] were through the bladder and then to suprapubic region outside [Figure 6].
Stents of substituted ureters left and right
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F6
The stents from both substituted ureters [Figure 5] were through the bladder and then to suprapubic region outside [Figure 6].
Histology of the excised fibrosed ureters showed features of severe schistosomiasis
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F7
The histology of the excised fibrosed ureters showed features of severe schistosomiasis [Figure 7].