{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,12]],"date-time":"2025-09-12T18:41:12Z","timestamp":1757702472821,"version":"3.33.0"},"reference-count":42,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2011,2,12]],"date-time":"2011-02-12T00:00:00Z","timestamp":1297468800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Urologia"],"published-print":{"date-parts":[[2011,10]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p> To describe the Sacral Hitch, vesical pexys to sacral promontory, an alternative technique to the Psoas Hitch when this is impossible to perform. We report intraoperative complications, and long-term functional results. <\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p> From 1989 to date we performed 66 ureteroneocystostomies (UNCS) (transbladder technique and Politano-Leadbetter antireflux plasty): 51 with ancillary \u201cPsoas Hitch\u201d (11 Casati-Boari); 15 with \u201cSacral Hitch\u201d because of the intraoperative finding of deficiency or lack of psoas tendon. Note of technique. Ureter and bladder are dissected as usual. Sacral Hitch: left lateralization of sigmoid and exposition of sacral promontory; longitudinal incision and divarication of peritoneum; smooth dissection of fat tissue, displacement of medium sacral vessels and visualization of neurovascular bundles. Direct fixation of the dome\/posterior aspect of bladder to anterior longitudinal ligament above promontory. <\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p> Among the patients who underwent the Psoas Hitch technique, 3 (5.4%) showed hypoesthesia, acute pain and impossible flexion of the thigh on hip with EMG positive for femoral (1) and genito-femoral (2) neuropathy. The re-operation in 2 cases solved the symptoms. One case resolved conservatively with corticoids, tricyclic antidepressants (Amitriptyline) and antiepileptics (gabapentin). Mean follow-up was 115 months (8\u2013252); two stenosis of anastomosis. <\/jats:p><\/jats:sec><jats:sec><jats:title>Sacral Hitch<\/jats:title><jats:p> (15 pts), mean follow-up: 47 months (range 4\u2013110), no stenosis of anastomosis 0%; transfusion rate 0%. <\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p> The psoas tendon deficiency or its congenital absence (children or women) requires the direct fixation to the muscle, an inadequate and weak target and housing of important sensitive-motor nerves (Genito-femoral, femoral and laterocutaneous). A \u201cPsoas-Syndrome\u201d could be present in 5.1% and a re-operation could be necessary. The sacral promontory represents an affixation target already successfully adopted in other surgery specialties (Gynaecology, Orthopaedic and General Surgery) and gives to UNCS a stiffness plate and an effective bladder cranialization. <\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p> Sacral Hitch Vesical Pexys represents an ancillary procedure to UNCS and surgeons should keep it in mind in cases of difficult finding of the psoas muscle tendon. <\/jats:p><\/jats:sec>","DOI":"10.5301\/ru.2011.8878","type":"journal-article","created":{"date-parts":[[2012,1,12]],"date-time":"2012-01-12T11:28:32Z","timestamp":1326367712000},"page":"274-282","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Sacral Hitch Vesical Pexy. A new Ancillary Technique for Ureteroneocystostomy"],"prefix":"10.1177","volume":"78","author":[{"given":"Giovannalberto","family":"Pini","sequence":"first","affiliation":[{"name":"Dep. Of Urology, Villa Salus Hospital, Gruppo Villa Maria Reggio Emilia - Italy"},{"name":"Dep. Of Urology, SLK Kliniken Heilbronn, Heilbronn - Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sergio","family":"Leoni","sequence":"additional","affiliation":[{"name":"Dep. 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