Ureteral injuries due to external violence: 10 years' experience with 59 cases

Fifty-nine cases of traumatic ureteral damage are presented. Gunshot wounds comprise the majority (52/59). Need for a high index of suspicion and aggressive diagnostic measures is stressed. The effects of missile velocity on the ureter are noted. Prompt operative management is advocated: choice of procedure depends on the location of the ureteral defect. Urinary complications occurred in 11/59 (19%). Four complications resulted from operative techniques no longer recommended. The death rate of 10% is related to the high incidence (57/59) of associated visceral and vascular injuries.