New viewpoints on urological injuries in pelvic surgery

After an exposure to a telecommunication meeting, discussing about the laparoscopic repair on ureteral injury, I was suprisingly inspired regarding the alternative method on managing ureteral injuries during pelvic surgery.
We can face these tough problems more optimistically, or even do the repair by ourselves, because the end-to-end reanastomosis using 4-0 vicryl, 4 stiches, getting a over 65% successful primary repair rate. The key point results in the success lies in early detection of the injury, the use and passage of the ureteral catheter or uteroscopic guide wire or tubing, and delicate suture technique. Above all, the essential trick is using Pyridium oral intake on day before operation to have urine encolored with darken brownish hue and make it stand out different to ordinary light yellow-colored urine. Make a easy identification on ureteral jets which come from non-injuried upper urinary tracts, if cystoscopy check is a routine after any pelvic surgery procedures. If any block in the injuried site occurred, accordingly, the ureteral jet flush will not be seen over the same side that got into troubles. Put on the stiches over trimmed or spatulated ends without using Loupe, not difficult,right? Then we have good stuff -- double J ureteral stents to put in the lumen to keep it patent and waiting for healing. Draumatic good end results for this small series of cases, that for sure will have a marvellous impact on the desire to copy all these expertise to our present day practice in open pelvic sugery.