Ureteral injuries during the course of surgical procedures within the pelvis occur more frequently than presumed. A series of 87 patients with ureteral injuries is reviewed from the standpoint of pathogenesis, diagnosis, treatment, end results, and prophylaxis. The ideal time for the repair of the injured ureter is at the time of operation or early in the period of convalescence. The procedure of choice is end-to-end anastomosis of the severed spatulated ends of the ureter. When this cannot be accomplished, reimplantation of the ureter into the bladder is recommended. Ligation of the proximal severed end of the ureter is rarely indicated, as a surgical procedure is now available that usually spares the kidney. Preoperative insertion of ureteral catheters as a precaution against ureteral injury is of questionable value.
Higgins CC. Ureteral Injuries During Surgery: A Review of 87 Cases. JAMA. 1967;199(2):82–88. doi:10.1001/jama.1967.03120020076013
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