Аннотация:Boari flap was undertaken, and histological examination confirmed the presence of a single pTaG 1 papillary transitional cell carcinoma in the lower third of the ureter. Subsequent cystoscopies at three and six months were normal. One year after the surgical procedure the patient developed painless haematuria. IVU demonstrated normal upper tracts and bladder, but cystoscopy revealed multiple superficial pTaGl papillary bladder tumours. These were managed with a combination of endoscopic treatment and intravesical chemotherapy with ethoglucid. The patient remained tumour-free for 2 years when he developed recurrent multiple pTaG1 bladder tumours. These were treated with transurethral resection and intravesical mitomycin, followed by intravesical BCG. The bladder became clear of tumour and remained so for over 3 years. However, despite normal cystoscopy the patient reported haematuria. On IVU the kidneys and bladder were normal but there was a filling defect in the reconstructed lower third of the right ureter (Figure 1). A right nephroureterectomy was performed with excision of a generous margin of the bladder, and histological examination revealed a single pTaG1 tumour in the Boari flap and another pTaGI tumour in the right renal pelvis.