[Is antireflux management of a ureteral lesion occurring during gynecologic surgery absolutely necessary?]. / Ist die antirefluxive Versorgung einer Ureterläsion bei gynäkologischen Operationen zwingend notwendig?

Gynaecological interventions are responsible for most of the (albeit rare) iatrogenic lesions of the ureter in the minor pelvis. After having recognised such a lesion intraoperatively, direct and definitive primary care should always be aimed at, i. e. ureterocystoneostomy according to the antireflux principle. This technique should be used also if a lesion has been recognised at a late stage only, for example, in case of ureteral fistulas and stenoses. Direct ureterocystoneostomy is now considered obsolete on account of the danger of reflux and the ensuing complications. Every surgeon performing surgery in the region of the minor pelvis should be familiar with the methods of bladder mobilisation and ureterocystoneostomy. If not, a urologically skilled expert should be consulted. This will avoid unnecessary re-operations involving additional risks for the patient.