[Traumatic lesions of the ureter in pelvic surgery. 9 cases (author's transl)]

Five cases were related to gynaecological surgery and 4 to operations involving the colon and rectum. In digestive surgery, the ureteric lesion was noted and repaired in 3 cases out of 4. By contrast, in gynaecology, it went unnoticed in all cases and was diagnosed and repaired after an interval varying from 6 weeks to 4 years after the trauma. 4 anti-reflux uretero-vesical reimplantations and one uretero-ureteric anastomosis were carried out, with complete success in all 5 cases. It is particularly striking to note that in gynaecological surgery 4 of the 5 ureteric lesions followed surgery for a non-malignant condition and that the ureteric trauma should have been easy to avoid, in particular by the preoperative insertion of ureteric catheters. By contrast, all the cases in digestive surgery were associated with operations for a carcinoma. In 3 cases out of 4, excision of the tumour necessitated the sacrifice of a segment of the ureter in the pelvis. One end-to-end ureteric suture failed, whilst 2 uretero-ureteric anastomoses were both successful.