Introduction: Ureteral lesions, most often iatrogenic, generally follow pelvic surgery. They are serious and can be life-threatening. Uretero-vesical reimplantation using the BOARI technique, modified by KUSS, was popularized in humans in 1954, and appears to be the most appropriate treatment for lesions of the lower ureter with significant loss of substance. Observation: We report in this work a case of iatrogenic ligation of the pelvic ureter on a single functional kidney (of fortuitous discovery) during gynecological surgery, having led to an Alteration of the General State (important Urinoma and collapse of the renal function) and treated by the surgical technique of BOARI KUSS at the urology department of the CHU Le Luxembourg. Follow-up and postoperative follow-up were excellent. Conclusion: Surgical repair of the ureter is very often indicated in cases of stenosis or iatrogenic lesions of the ureter. The BOARI KUSS technique is a good choice in cases of significant loss of substance due to injury to the lower ureter. Gynecological surgery is the main source of these lesions, and the prognosis of the treatment depends on how early the diagnosis is made, the anatomical condition of the ureter and the expertise of the surgical team.
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