When a ureteral injury is identified at the time of surgery in a patient who is haemodynamically unstable, immediate definitive repair is not always feasible. The clinical priority shifts to patient survival, and a staged approach becomes necessary.
Intraoperative ureteral injury — recognised immediately during surgery — in a patient who is haemodynamically unstable. Physiological instability in this setting drives management toward a temporising, damage-control strategy rather than primary definitive ureteral reconstruction.
The preferred strategy in this setting is a damage-control approach: temporising measures to secure urinary drainage and preserve renal function while haemodynamic stability is re-established. Definitive ureteral repair is deferred.
The full structured protocol details the specific interventions, sequencing, and criteria for delayed repair — available via the link below.