Abstract: Objective To investigate the curative effect of spiral suture of longitudinal trapezoidal flap in preventing the tightness of the pedicle and the atrophy and collapse of the nipple after ureteropaplasty.Methods A retrospective analysis was performed on the clinical data，incidence of postoperative dermal papillary atrophy and collapse，and outcomes of 15 elderly patients who underwent total cystectomy and total bladder combined with partial ureterectomy in general surgery department of zhengzhou university affiliated cancer hospital from January 2013 to December 2016.Among the 15 cases with longitudinal trapezoidal flap spiral suture，12 cases had good ureteral length and blood supply.Due to the insufficient length of ureter in 3 cases，it was difficult to form the same side of ureter on both sides，and the dermal papilla of ureter was formed on both sides respectively.Results One of the 18 nipples collapsed，with an incidence of 5.56%.One papillary root infection resulted in ureteral flap root fistula，with an incidence of 5.56%.One nipple showed distal ureteral necrosis，with an incidence of 5.56%.The comprehensive incidence of complications was 16.7% and all the patients had no problems of skin flap necrosis and nonunion，skin flap pedicle tightness，nipple atrophy and collapse，etc.Conclusion The longitudinal trapezoidal flap spiral suture can effectively prevent the tightness of the pedicle and the atrophy and collapse of the nipple after ureteropaplasty.

Key words: longitudinal trapezoidal flap, spiral suture, ureteral papilla