Injuries of the pelvic ureter

Ureteral injuries may cause infection, fistula, and even death. By revealing abnormalities, preoperative pyelography warns the surgeon of hazards to be anticipated. Injury found during operation is managed by reimplantation, reanastomosis, or ureterostomy in situ, while deliberate ligature is avoided. Postoperative ureteral fistula is treated by reimplantation, although occasionally a tongue of reflected bladder wall converted into a tube is required. In the absence of skilled urologic advice, ureteral injuries may be managed by the gynecologist.