Jeffrey M Fowler

Repair of ureteral injuries Introduction

Ureteral injury occurs in 1-2% of all major gynecologic procedures. Pelvic irradiation, large pelvic tumors, endometriosis and the radicality of the procedures all increase the risk of damage. Ureteral obstruction can also occur as a result of any of the above processes, necessitating reimplantation. The underlying principles to be adhered to in repairing any ureteral injury are:

1. Adequate vascular supply.

2. Adequate surgical exposure.

3. Gentle tissue handling.

4. Tension-free suturing.

5. Placing the minimum number of sutures.

6. Stenting to allow the repair to heal.

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