Wolf B, Espig O, Stolzenburg JU, et al. - Researchers conducted a retrospective cohort study with historic control in order to appraise the feasibility and effect of mesureteral preservation on urinary complications in the context of total mesometrial resection (TMMR), a surgical treatment for cervical cancer. They assessed women older than 18 with primary cervical cancer staged FIGO IB1 - IIB who were recruited in the prospective Leipzig School MMR study and had undergone TMMR without adjuvant radiation. They performed a retrospective analysis of 100 consecutive TMMR procedures with preservation of the mesureter performed for cancer of the uterine cervix (intervention group, January 2014 – June 2017). A comparison of this group was done to the previous 100 consecutive TMMRs that were performed before the introduction of mesureteral preservation (control group, September 2010-January 2014). They identified the mesureter as a useful dissection plane that allows the preservation of lateral ureteral blood supply during TMMR. Outcomes here support the feasibility of undertaking mesureteral preservation and suggest it be linked with a significant reduction in ureteral complications (11% without mesureteral preservation vs 3% with mesureteral preservation). In addition, a significant reduction was observed in the number of postoperative percutaneous nephrostomies and re-operations (7% vs none) with a trend towards a reduction in other urinary complications, such as postoperative bladder atony and uretero-vaginal fistulas, in correlation with procedures with mesureteral preservation. Further, findings suggest the possible utility of mesureteral preservation in other types of pelvic surgeries with a high risk of ureteral damage.