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Ureteral avulsion is a rare but well known complication of ureteroscopy, almost always related to the use of an ureteroscope too large to be readily accommodated by the ureter or, in most cases, by an attempt to pull an inadequately fragmented or impacted stone down from the proximal or mid ureter.
In case 3, there was a âdeglovingâ injury, which is not a ureteral avulsion. Rather, this is simply an intussusception of ureteral mucosa, which can often be managed with a stent, as the authors did here. Ureteral avulsion is a rare injury, the risks for which are well described and reiterated in this paper.