ONE OF the major hazards in radical pelvic surgery for malignant disease is injury to the ureters. The purpose of this report is to describe a method of repair of the ureter when the site of injury is in the lower segment, i. e., that portion lying within the parametria.
If the transection is complete, a no. 7 or 8 (French) ureteral catheter is inserted upward in the upper segment and the lower end of the catheter is then placed into the lower segment and pushed into the bladder. The whole catheter is then threaded downward, coiling in the bladder until the upper tip is about 8 to 10 cm. above the site of injury. The transected ureter is repaired over the catheter, four or five interrupted 00000 surgical gut sutures with an atraumatic needle being used. The posterior-superior portion of the bladder is grasped with Allis clamps and pulled