This protocol covers ureteral injury that was not recognised at the time of the original operation. Delayed diagnosis is the rule rather than the exception in both blunt and iatrogenic trauma. Initial management typically proceeds with endo-urological measures; surgical repair becomes the necessary next step when those measures are insufficient.
When endo-urological treatment fails, open or robot-assisted laparoscopic surgical reconstruction of the ureter is required. The technique chosen depends on which segment of the ureter is affected and how much length has been lost — a spectrum of reconstructive options is applied accordingly, from primary anastomosis for limited defects to more extensive procedures for long-segment loss.