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

OBJECTIVE: There are many causes of ureteral injury being the main one iatrogenic. The reconstruction depends on the injury's location and length. In some complex cases, we must do ureteral reconstructions using bowel segments. These techniques are a challenge for the surgeon and are not exempt of short and long-term complications. Our purpose is to present three complex ureteral injury cases, and to analyze the main technical variants. PATIENTS AND METHODS: We present three clinical cases with long length ureteral injuries treated in our hospital. RESULTS: None of the cases presented had complications in the immediate postoperative period. In long term, all of them had mechanical complications, needing urinary diversion and reintervention in two cases. However, no metabolic disturbances or kidney function deterioration have been reported. At present the three patients have a good clinical condition. CONCLUSION: The repairment of complex ureteral injuries is a safe and effective procedure, but it needs a great knowledge of the anatomy, the different techniques described and the patient's characteristics. It is recommended to be performed in experienced centers.