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Introduction: lItrogenic ureteral injuries can occur during various abdominopelvic and retroperitoneal surgical procedures including gynecological, urological, colorectal and vascular., Objective: The aim of our study was to examine the incidence and types of iatrogenic ureteral injuries occurred over the period of 16 years, as well as to evaluate the values of applied diagnostic and therapeutic procedures., Methods: A retrospective analysis of clinical data (medical records and operative reports) of 55 patients (11 male and 44 female; mean age 54.5 years) with verified iatrogenic ureteral injury from 1998 to 2014, was performed., Results: latrogenic ureteral injuries occurred during gynecological procedures in 55%, urological in 25%, colorectal in 15% and vascular in 5% of cases. Mechanisms of injury were incomplete transection (n=23), complete transection (n=1), ligation (n=7), partial perforation (mucosal abrasion) (n=1 3) and total perforation (n=1). The most frequent diagnostic procedures for postoperative identification of ureteral injuries were abdominal ultrasonography, excretory urography, antegrade pyeloureterography and retrograde ureteropyelography. Early therapeutic procedures were applied in 35 (64%), while delayed in 20 cases (36%). Early (<30 days) or late (>30 days) postoperative complications were verified in 14 cases (25%)., Conclusion: Among different surgeries that may lead to the development of iatrogenic ureteral injury, gynecological procedures represent the most common cause. Rapid diagnosis enables immediate ureteral repair and is associated with low morbidity rates, representing a major factor contributing to the treatment success and ultimately preserving the renal function.

Objective: to analyze complications and clinical outcome of Camey-Le Duck ureteral reimplantation technique in modified Mainz pouch II urinary diversion., Patients and Methods: this retrospective study included a total of 110 patients (101 male and 9 female, mean age 59.2 years, SD = 10.2), who had underwent a modified Mainz pouch II urinary diversion with Camey-Le Duck ureteral reimplantation technique, following total cystectomy, during the period 1995-2014. The mean follow-up, available for 90 (82%) patients period was 19 (1-74) months. Early and late postoperative complications were analyzed., Results: early complications developed in 22 (20%) patients as follow: unilateral ureterohydronephrosis in 8 (7%) patients, bilateral ureterohydronephrosis in one (1%)-two RU (renoureteral units), urinary leakage in 8 (7%), and pyelonephritis in 5 (5%) patients. Late complications developed in 28 (25%) patients: pyelonephritis in 17 (15%), and ureteral reimplantation site stenosis in 11 (10%) patients with 12 RU. Balloon dilatation procedure was applied in all 12 RU, with additional metallic Strecker stent insertion in 5 RU. At 24-month follow-up, all patients with metallic Strecker stent had normal results of serum biochemistry, blood gas analysis and renal ultrasound. In the rest of six patients with 7RU, balloon dilatation has failed and restenosis of ureteral reimplantation site with consequent ipsilateral hydronephrosis was verified. In these patients, permanent percutaneous nephrostomy catheter was applied., Conclusion: Camey-Le Duck ureteral reimplantation technique following Mainz pouch II urinary diversion is simple, reliable and durable. It enables well upper urinary tract protection and is associated with relatively low major complication rates.

Introduction: Uretero-intestinal anastomisis has a large influence on derivation quality., Objective: The aim of the study was to present the modified serous lined extramural Abol-Enein method of implantation of low quality ureter into the sigma-rectum pouch and comparison of the results with Le Duc implantation., Methods: From 1995 to 2009, 62 dilated ureter units were implanted in the detubularized rectosigmoid urinary reservoir. In 28 units Le Duc, and in 34 Abol-Enein method was done. Urinary fistula and ileus were considered as early complications, while late complications included stenosis and reflux pyelonephritis. Frequency of urination was considered as a parameter of functionality., Results: Transitory urine fistulae occurred only in the ureters implanted according to Le Duc technique in 4/28 (14.2%); the difference between the examined groups was close but still below the level of statistical significance (p = 0.07). Iieus occurred with nearly equal frequency in both groups. Stenosis on the ureteral implantation place was significantly more frequent (p = 0.04) in the Le Duc group 5/28 (21.7%) than in the Abol-Enein group 0/34 (0%). Refluxive pyelonephritis occurred in 3/34 (8.8%) of the Abol-Enein group, and in 5/28 (21.7%) of patients in the Le Duc group. Concerning the daily frequency, there was no difference between the examined groups., Conclusion: Uretero-intestinal anastomisis of dilated ureters through a serous-lined extramural tunnel decreases the risk of reflux in a considerable number of patients, with an acceptable level of complications. There are several advantages in comparison with Le Duc method.