[Surgical repair of complex ureteral injuries: three clinical cases and analysis of different technical approaches.]

There are many causesof ureteral injury being the main one iatrogenic.The reconstruction depends on the injury´s locationand length. In some complex cases, we must do ureteralreconstructions using bowel segments. Thesetechniques are a challenge for the surgeon and arenot exempt of short and long-term complications.Our purpose is to present three complex ureteralinjury cases, and to analyze the main technical variants. PATIENTS AND METHODS: We present threeclinical cases with long length ureteral injuries treatedin our hospital. RESULTS: None of the cases presented had complicationsin the immediate postoperative period. Inlong term, all of them had mechanical complications, needing urinary diversion and reintervention in twocases. However, no metabolic disturbances or kidneyfunction deterioration have been reported. At presentthe three patients have a good clinical condition. CONCLUSION: The repairment of complex ureteralinjuries is a safe and effective procedure, but itneeds a great knowledge of the anatomy, the differenttechniques described and the patient´s characteristics.It is recommended to be performed in experiencedcenters.