Introduction
Ureter runs in the major pelvis over the iliac vessels and through the
uterine artery; thus, it is vulnerable to iatrogenic damage in pelvic
surgery (1). Owing to the rise in the total number of surgical
procedures and the widespread use of minimally invasive surgical
methods, the occurrence of iatrogenic ureteral injury (IUI) has
increased (2, 3). Non-urologic IUI cases are often detected post
gynecological surgery (4). The frequency of IUI is greater than that of
open surgery following laparoscopic hysterectomy (5). Ureter is commonly
injured in the lower 1/3 segment, located between the uterine artery and
ureterovesical junction (6).
Early diagnosis and immediate repair can minimize ureter-related
complications during long-term follow-up (7), although most cases can be
detected in the postoperative period (8). The location of the traumatic
segment and the type of injury are decisive for the surgical approach
chosen for the treatment (9). Ureteroureterostomy or ureteral
reimplantation is recommended for the middle and distal ureteral injury
(10, 11). However, some studies suggest endourological intervention for
first-line treatment in the IUI (12-15). The success rates have been
documented across such a broad spectrum due to the heterogeneity of IUI
etiology, the low density of cases, and the diversity of treatment
options (17-84%) (13-18).
here is no study investigating the effect of treatment results according
to injury types the ureter. We aimed to evaluate the etiological factors
and their effects on long-term clinical outcomes in patients with IUI.