title: Endoscopic rendezvous procedure for ureteral iatrogenic detachment: report of a case series with long-term outcomes.
abstract: OBJECTIVE
  Injury to the ureter is the most common urologic complication of pelvic surgery, with an incidence that ranges from 1% to 10%. Most cases of ureteral injuries are related to gynecologic procedures. The ureter is particularly vulnerable to detachment or ligation during hysterectomy because of its position from the lateral edge of the cervix. We report a case series of female patients who underwent the ureteral rendezvous procedure for ureteral detachment.
  
  
  METHODS
  Between January 2009 and April 2013, 18 ureteral rendezvous procedures were performed for patients with complete detachment. We assessed the operative and clinical outcomes of these patients over a mean follow-up duration of 26.5 months and describe the three most representative cases.
  
  
  RESULTS
  The endoscopic rendezvous technique was performed in all cases to manage ureteral detachment. CT urography at discharge and 6 and 12 months after discharge confirmed the restoration of ureteral integrity without any leakage in 66% (12/18) patients, indicated ureteral stenosis in 22% (4/18) patients, and indicated ureteral leakage in 12% (2/18) patients. The overall long-term success rate for all 18 patients was 78% (14/18) at a mean follow-up of 26.5 months.
  
  
  CONCLUSIONS
  The endoscopic rendezvous procedure reduces the need for invasive open surgical repair and represents the optimal initial option in patients with iatrogenic ureteral lesions before invasive procedures with higher morbidity are attempted.
authors.affiliation: Department of Medico-Surgical Sciences and Biotechnologies, Urology Unit, ICOT, Faculty of Pharmacy and Medicine, Sapienza University of Rome , Latina, Italy .
authors.forename: Antonio Luigi
authors.initials: AL
authors.lastname: Pastore
authors.forename: Giovanni
authors.initials: G
authors.lastname: Palleschi
authors.forename: Luigi
authors.initials: L
authors.lastname: Silvestri
authors.forename: Antonino
authors.initials: A
authors.lastname: Leto
authors.forename: Domenico
authors.initials: D
authors.lastname: Autieri
authors.forename: Andrea
authors.initials: A
authors.lastname: Ripoli
authors.forename: Cristina
authors.initials: C
authors.lastname: Maggioni
authors.forename: Yazan
authors.initials: Y
authors.lastname: Al Salhi
authors.forename: Antonio
authors.initials: A
authors.lastname: Carbone
mesh_terms: D000328:Adult; D003251:Constriction, Pathologic; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects*; D007049:Iatrogenic Disease; D008875:Middle Aged; D009403:Nephrostomy, Percutaneous / Q000379:methods; D011183:Postoperative Complications; D025321:Surgery, Computer-Assisted / Q000379:methods; D014513:Ureter / Q000293:injuries* / Q000601:surgery; D014515:Ureteral Diseases; D018666:Ureteroscopy / Q000379:methods*; D014567:Urography