Objective To investigate ureteral injury during gynecological laparoscopic surgeries.Methods From January 1990 to December 2005

12868 gynecological laparoscopic surgeries were conducted in Peking Union Medical College Hospital with 12 ureteral injuries reported. The present study investigated several aspects

including surgical indications

uterine size

pelvic adhesion

operative procedures

symptoms

diagnostic time and methods

injury site and type

subsequent treatment

and prognosis. Results The incidence of ureteral injury was 0.093% （12/12868） in all cases

0.42% （11/2586） in laparoscopic hysterectomy [laparoscopically assisted vaginal hysterectomy （LAVH） or total laparoscopic hysterectomy （TLH）]

and 0.01% （1/10282） in non-LAVH surgeries. Enlarged uterus

pelvic adhesion

and endometrosis were risk factors associated with ureteral injury. Only one injury was found intraoperatively while others were found postoperatively. The injury sites were at the pelvic brim （2 cases） or the lower part of ureter （10 cases）. Patients were treated with ureteral stenting （effective in 2 cases） or laparotomy and open repair. Prognoses were favorable in most cases. Conclusions Most laparoscopic ureteral injuries occur during laparoscopic hysterectomy. Further evaluation is required when ureteral injury is suspected

and surgical repair is the major treatment for ureteral injury.