Introduction: 0% of all urinary tract injuries are iatrogenic lesions. Although they only occur in < 5%, they can lead to severe ipsilateral renal dysfunctions. These lesions can be treated with extensive knowledge on the genesis of the lesion, the anatomy, the individual patient’s history and high operative expertise in diverse surgical methods. Material and Methods: In this article, we show which reconstruction options are possible, depending on the lesion’s severity according to the AAST and EAU Guidelines from 2009 on the classification of ureter injuries, as well as the localisation. A special focus is on the anatomy. It is important to adhere to surgical ground principles, such as making sure all pathological tissue is removed, the ureter ends are spatulated and a tension-free and watertight anastomosis is maintained. Results: Iatrogenic ureter lesions are rare complications, but being able to deal with these frequently requires a urologist’s expertise. Whenever surgeons operate close to the ureters, there is always a risk of an iatrogenic ureter lesion, which in turn requires that all available reconstructive measures are used dynamically. Conclusion: Ureter complications are rare but require surgeons’ excellent management expertise.

Introduction: A surgeon is constantly faced with the question to preserve the kidneys and their function for diverse lesions of the ureter. Often these lesions limit the kidneys in their performance.

The focus of these efforts is standardization of the procedure and protection of the kidney donor. This is also reflected in the recommendations for organ removal technique and the selection of the organ to be used for kidney donation.

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