A 34-year-old female patient underwent total hysterectomy and pelvic irradiation for uterine malignancy, which led to iatrogenic fibrotic injury of the distal ureter. Reconstructive surgery was performed, and the ureter was replaced by an isolated ileal segment. Ureteroileal anastomosis was created using the antireflux serous-lined extramural tunnel technique, while the distal end of the isolated ileal segment was widely anastomosed with the bladder. Within a 1-year follow-up, excellent results were achieved, with complete recovery of the patient's renal function and previous quality of life. This technique could be a viable option when large ureteral defects are encountered.
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