Objective: To evaluate the surgical outcomes of iatrogenic distal ureteral injury repair using the modified Lich–Gregoir ureteroneocystostomy technique, focusing on perioperative parameters, complications, and long-term functional results.

Materials and Methods: In this retrospective analysis, 23 patients who experienced iatrogenic distal ureteral injuries underwent repair using the modified Lich–Gregoir technique from January 2021 to January 2025. The preoperative evaluation included tests such as serum creatinine, urinalysis, renal ultrasound, and cross-sectional imaging, with selective use of retrograde pyelography or renal scintigraphy. Surgical outcomes were measured by examining ureteral patency, renal function, operative details, and complications, which were categorized using the Clavien–Dindo classification. Patient-reported outcomes were assessed through the Patient Global Impression of Change (PGI-C) scale.

Results: The study included 11 men and 12 women, with a median age of 44 years. Gynecological surgery was the leading cause of injury, accounting for 52.2%, followed by urological surgery at 39.1%, and colorectal surgery at 8.7%. The median duration of surgery was 150 minutes, and patients typically stayed in the hospital for 4 days. A psoas hitch procedure was conducted in 3 patients, representing 13.0% of the group. The median follow-up period was 22 months. All patients (100%) experienced successful surgical outcomes. Complications were noted in two patients, with each experiencing a urinary tract infection and a wound infection, both at a rate of 4.3%. Based on PGI-C scores, 95.7% of patients felt "very much improved," while 4.3% reported being "much improved."

Conclusion: The Lich–Gregoir ureteroneocystostomy, when modified, offers a reliable, safe, and effective surgical solution for treating injuries to the distal ureter caused by medical procedures.

Keywords : iatrogenic disease; surgical procedures; ureteral injuries; ureteroneocystostomy