Commonest cause of ureteric injury during surgical operation is:

(Hystrectomy) (1312-Baily & Love 24th) (2275-SB) (1292-B &L 25th)Ureteric injury during operations* The most common cause of injury to the ureter is surgical trauma during hysterectomy or other pelvic surgery* Pre operative catheterization of the ureter makes then easier to identify during surgery.* Injuries discovered at the time of surgery should be repaired immediately.Methods for repairing a damaged ureter* It there is no loss of length - Spatulation and end to end anastomosis* If there is little loss of length - Mobilise kidney, psoas hitch of bladder Boari operation* If there is marked loss of length -- T ransureterostomy- Inter position of isolated bowel loop or mobilized appendix- Nephrectomy* Injuries to the lower third of the ureter - procedure of choice is reimplantation in the bladder combined with psoas- hitch procedure to minimize tension on the ureteral anastomosis* Midureteral injuries - can be managed with primary uretero ureterostomy. If there is not a significant loss of viable ureter between the proximal and distal sites of injuries, otherwise trans ureteroureterostomy is a good option.* Upper ureteral injuries - are best managed with primary ureterostomy. If there is extensive loss of the ureter, autotransplantation of the kidney and transposition of bowel to replace the ureter are potential surgical options.