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Research Article | DOI: https://doi.org/10.31579/2768-2757/200
Independent Researcher.
*Corresponding Author: Sinisa Franjic., Independent Researcher.
Citation: Sinisa Franjic., (2026), Numerous Diseases Can Affect the Ureters, Journal of Clinical Surgery and Research, 7(2); DOI:10.31579/2768-2757/200
Copyright: © 2026, Sinisa Franjic. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Received: 16 February 2026 | Accepted: 27 February 2026 | Published: 10 March 2026
Keywords: pelvic; ureter; woman; surgery; health
Ureters are smooth muscle tubes that transport urine from the kidneys to the bladder. Various medical conditions can impact the ureters. The ureter begins at the renal pelvis, descends through the retroperitoneal space within the abdominal cavity, and enters the pelvic region, ultimately draining into the urinary bladder. Consequently, it can be categorized into abdominal and pelvic segments. As the ureter enters the pelvic cavity, it creates a curved shape, and in this narrowed section, a kidney stone can become lodged.
Injury to the ureters is an uncommon occurrence, predominantly caused by iatrogenic factors during open, minimally invasive, or endoscopic surgeries [1]. Most non-iatrogenic ureteral injuries result from penetrating traumas. The aftermath of undetected ureteral injuries can vary, leading to issues such as urine leakage and abscess formation, as well as more serious complications like ureteral stricture, renal function loss, sepsis, urinary fistula, or even fatality. Often presenting subtly, ureteral injuries necessitate a keen awareness to prevent severe complications from unnoticed or improperly treated injuries. Iatrogenic injuries to the pelvic ureters frequently occur during hysterectomies and colorectal surgeries; urological and vascular surgeries also significantly contribute, although at a lower rate, to pelvic ureteral injuries. Injuries to the ureters from external traumas are unusual, seen in less than 4% of penetrating injuries and under 1% of blunt injuries. In cases of penetrating trauma, injuries may result not only from direct cuts but also indirectly from damage to the ureter's blood supply. Over 90% of individuals with ureteral injuries also have concurrent damage to abdominal or retroperitoneal organs, with a mortality rate associated with these injuries reaching around 30%.
Pelvic Floor
Pelvic floor disorders affect approximately 25-30% of women, posing a significant social issue, particularly with the increasing average age and life expectancy [2]. Numerous conditions can influence pelvic anatomy and function, including pelvic organ prolapse, bladder and bowel dysfunction (such as incontinence, urinary retention, constipation, etc.), weakness of pelvic muscles and connective tissues, pelvic pain, sexual dysfunction, and neurogenic changes. Various treatment options have been documented for pelvic floor disorders, encompassing pharmacological, rehabilitative, surgical, and behavioral strategies, highlighting the complexity of this interconnected anatomical and functional system. Sacral neuromodulation (SNM) employs electrical modulation to influence the bladder, rectum, and other pelvic organs' physiological functioning. Initially used for bladder dysfunction, its previously unexamined beneficial impact on intestinal functionality has led to its potential application in bowel function as well. Currently, specific indications for SNM are well defined and included in clinical guidelines, though its broader implementation is still restricted by costs and the need for specialized expertise. For alternative conditions, research is ongoing, with some findings indicating promising outcomes. To achieve similar results from neural modulation, percutaneous tibial nerve stimulation (PTNS) has been suggested. However, when compared to SNM, PTNS appears to be less effective and has less supporting evidence for its application. The surgical intervention of sacral neuromodulation involves placing the electrode through one of the openings in the sacrum, typically at the S3 level, following bilateral assessments of sensitive and motor responses. The electrode is then connected to either a subcutaneous or external pulse generator. Although a complete comprehension of how sacral neuromodulation works is not fully established, various possible effects have been noted that engage the brain, spinal cord, peripheral pathways, and reflex systems. Nonetheless, having treated over 300,000 patients globally with sacral neuromodulation, this treatment modality is poised to become a significant option in the future, as part of the growing array of therapeutic methods utilizing a neural-computer interface.
Bleeding
Managing bleeding in the right upper quadrant, situated behind the liver, is often very challenging, and it is considered acceptable to pack this area for a duration of 24 to 48 hours [3]. Should recurrent bleeding occur upon the removal of packs, the liver may need to be moved out of its fossa, potentially requiring the placement of a chest tube from the inferior vena cava to the right atrium to facilitate repairs to the retrohepatic vena cava's posterior aspect. Damage to the right renal vein typically leads to the loss of that kidney (assuming the left one is functioning normally); if repair is necessary, the simplest method is to autotransplant it to the right iliac artery and vein after cooling it with iced heparinized saline to extend the tolerable ischemia time of 4 to 6 hours. Any hematomas affecting the kidneys should be assessed prior to making decisions. Arterial reconstruction can be performed using an interposition graft fashioned from either the saphenous or jugular vein (in the absence of a prosthetic graft), connecting the renal artery to the hepatic artery on the right and to the splenic artery on the left. Injuries to the iliac vessels can be revealed by extending the midline incision, and following control of any bleeding, the internal iliac artery can be utilized to bypass damage to the external iliac artery or be ligated and divided, which will provide better access to the iliac veins. It is preferable to ligate the iliac veins at the common iliac rather than the external iliac to better preserve the pelvic collateral circulation. Repairing these veins carries risks of stenosis with the potential for thrombosis and pulmonary embolisms. Distal injuries to the internal iliac vein can be best managed with packing. Throughout these dissection procedures, it is crucial to handle the femoral nerve located laterally next to the vein and the ureter situated medially as it traverses the common iliac artery with great care. Vessels measuring less than 3 mm may be ligated, whereas those exceeding 3 mm should be suture-ligated; vessels larger than 5 mm may be closed with a continuous suture for low-pressure vessels and two layers for those in high-pressure situations. During repair work, it is essential to only minimally contact the intima or avoid it altogether entirely, utilizing stay sutures instead. Proper sizing of the patch is vital to prevent oversizing, aneurysmal dilation, and thrombus formation. For smaller vessels, both ends should be spatulated, and employing a sterile angiocath or feeding tube at both ends of the anastomoses will assist in preventing the suturing of two walls together.
Pain
Pelvic pain may be linked with either regular or irregular menstrual cycles and can arise from issues within the pelvis or be felt as referred pain from other body parts [4]. A strong suspicion should be maintained for non-pelvic conditions that might cause pain in the pelvic region, such as appendicitis, diverticulitis, cholecystitis, bowel obstruction, and infections in the urinary tract. A comprehensive patient history detailing the nature, location, radiation, and changes in intensity of the pain will assist in determining the origins of acute pelvic discomfort. It is important to assess whether the pain coincides with vaginal bleeding, sexual intercourse, bowel movements, urination, physical activity, or eating. Distinguishing between acute or chronic pain, and whether it is consistent or intermittent, as well as cyclic or noncyclic, will guide subsequent examinations. Pelvic inflammatory disease typically manifests as pain in the lower abdomen on both sides. Testing for C. trachomatis and N. gonorrhea is advisable for women who are at a higher risk. If the pain is unilateral, it may indicate issues with the adnexa, such as rupture, bleeding, or twisting of ovarian cysts, or, although less often, tumors in the ovaries, fallopian tubes, or surrounding areas. Ectopic pregnancy is characterized by lower abdominal pain on one side, accompanied by vaginal bleeding and irregular menstrual cycles, with clinical symptoms appearing 6 to 8 weeks after the last normal period. Signs of orthostatic changes and fever may also present. Pathologies affecting the uterus include endometritis and degenerating leiomyomas. Many females notice discomfort in the lower abdomen during ovulation (mittelschmerz), described as a dull, aching sensation occurring around the middle of the cycle lasting from several minutes to a few hours. Women who ovulate may also have physical symptoms in the days leading up to menstruation, such as swelling, breast fullness, and bloating or unease in the abdomen. A collection of symptoms comprising cyclic irritability, sadness, and fatigue is referred to as premenstrual syndrome (PMS). Severe cramping associated with ovulatory periods, where no obvious pelvic disorders are present, is identified as primary dysmenorrhea. In contrast, secondary dysmenorrhea results from underlying pelvic issues like endometriosis, adenomyosis, or cervical narrowing. Assessment involves taking a detailed history, conducting a pelvic examination, measuring hCG levels, performing tests for chlamydial and gonococcal infections, and utilizing pelvic ultrasound. In certain situations where the cause of pelvic pain is unclear, laparoscopy or laparotomy may be warranted.
Injury
The ureters are structures located behind the peritoneum that transport urine from the kidneys' renal pelvis to the bladder [5]. They begin at the ureteropelvic junction (UPJ), situated behind the renal artery and vein. Moving towards the pelvis, the ureters follow the path along the psoas muscle. Before connecting to the bladder’s trigone, the ureter crosses over the iliac bifurcation. The ureter can be categorized into three anatomical parts: the proximal ureter, which stretches from the UPJ to the sacroiliac (SI) joint; the middle ureter, which is located between the SI joint and the pelvic brim; and the distal ureter, which runs from the iliac vessels to the bladder. Although ureteral injuries are not frequent, they can occur as a complication during any surgical procedures in the abdominal or pelvic regions. It is understandable that injuries to the distal ureter are common, given their close association with the pelvic blood vessels, which include the iliac vessels, uterine artery, and rectal arteries. The upper third of the ureter receives its blood supply from the aorta and renal vessels, which can be found medial to the ureter. The lower two-thirds of the ureter are supplied by vessels from the iliac, sacral, and lumbar regions, located lateral to the ureter. The positioning of the blood supply to the ureter is essential to consider, as devascularization is a frequent type of injury and typically manifests later. The severity of ureteral injuries can be assessed using a grading system from I to V. A grade I injury is characterized by a hematoma or contusion that does not involve devascularization, while a grade II injury indicates less than 50% transection. A grade III injury refers to more than 50% transection, a grade IV injury consists of a complete transection with less than 2 cm of devascularization, and a grade V injury denotes an avulsion with over 2 cm of devascularization.
Recognition
The prompt identification of a ureteral injury is vital to reduce potential long-term complications [1]. The most immediate detection of an iatrogenic ureteral injury occurs during the operation itself. Strategies to prevent such injuries include the placement of ureteral stents during surgery to assist in locating the ureters. These ureteral stents are frequently requested or utilized by surgeons in gynecology, colorectal, and vascular specialties, due to the anatomical closeness to the ureters. Although the preventive use of these stents may help with identifying ureteral injuries, their effectiveness in reducing the overall incidence of injuries remains uncertain. However, a recent analysis of the National Surgical Quality Improvement Program indicated a reduced frequency of ureteral injury following colectomy when ureteral stents were employed. In numerous cases, anatomical alterations of the ureter arise due to mass effects from gynecological or colorectal tumors, or fibrosis caused by aortic aneurysms, which complicate the recognition or dissection of the ureter, thus elevating the risk of injury. Postoperative diagnosis and localization of ureteral injuries demand a keen level of awareness, as these injuries can present with various signs and symptoms. This vigilance becomes even more crucial in laparoscopic or robotic surgeries; while approximately one-third of ureteral injuries are identified during open surgical procedures, fewer are detected through minimally invasive techniques. Depending on the clinical condition of the patient, the identification of ureteral injuries can occur immediately or at a later stage. Indications such as fever, ileus, hematuria, leukocytosis, tenderness, or expansion of the abdomen, along with an increase in serum creatinine due to the peritoneal absorption of urine or an obstructed kidney, can point towards a ureteral injury that leads to peritoneal irritation, urinoma, or abscesses. If a surgical drain has been inserted during surgery, fluid can be evaluated for spot creatinine levels; urine leakage may be indicated if spot creatinine exceeds serum creatinine. If renal function allows for the use of intravenous contrast, a CT scan of the abdomen and pelvis with contrast and a delayed urographic phase serves as an efficient method for identifying the site of the ureteral injury. A retrograde pyelogram is the most precise tool available to determine the injury’s location and may facilitate the concurrent cystoscopic placement of a ureteral stent, depending on the severity of the injury.
Repair
The process of repairing ureteral injuries is intricate and necessitates excellent judgment, skill, and experience [6]. A surgeon who has comprehensive understanding and familiarity with this repair type should conduct it. Typically, injuries identified during surgery or within the initial days of recovery in a stable patient are addressed immediately. In cases where the patient is unstable or if the detection of the injury is postponed for days or weeks, immediate proximal urinary diversion should occur, followed by a delayed repair. Generally, proximal urinary diversion can be accomplished through the insertion of a percutaneous nephrostomy catheter. In situations where the ureter has been unintentionally ligated during surgery, simply removing the suture may be sufficient. Conversely, if the ureter has suffered crushing due to a clamp, the chance of injury is significantly higher. A thorough examination of the adventitia for discoloration is essential, as ischemic damage can take several days to become fully apparent. If the adventitia is found to be nonviable, a repair should be undertaken. Fundamental principles governing ureteral repair include the removal of nonviable tissue, achieving tension-free anastomosis, and approximating the mucosa-to-mucosa. Partial transections are typically managed with direct closure using interrupted 4-0 or 5-0 absorbable sutures. Complete transections and cases involving ischemic injury may necessitate resecting the damaged section followed by ureteroureterostomy. All ureteral repairs, whether primary closures or ureteroureterostomies, should be drained extraperitoneally. All complete transections and the majority of partial transections should be stented, such as with a double J stent. Complete transection of the pelvic ureter or significant ischemic damage is often best treated through ureteral reimplantation. When anticipating a challenging surgery, such as with a significant cancerous tumor, an inflammatory mass in the pelvic region, or cases involving extensive radiation therapy, the likelihood of damage to the ureters can be reduced by placing ureteral catheters before the operation. This strategy facilitates the identification of the ureters, though it does not completely guarantee the prevention of injury.
Surgery
A urological surgeon dealing with ureteral injuries must possess a comprehensive knowledge of the ureters' anatomy and trajectory [1]. The ureter can be categorized into three separate portions: (1) the proximal ureter, which spans from the junction of the ureteropelvic area to the upper section of the sacrum; (2) the middle ureter, which travels from the upper part of the sacrum to the iliac blood vessels; and (3) the distal ureter, which ranges from the iliac vessels down to the urinary bladder. Moreover, familiarity with the ureter's closeness to adjacent anatomical structures is essential for preventing, recognizing, and effectively treating ureteral injuries. Originating in the upper retroperitoneum, the ureters are positioned atop the psoas muscle in the retroperitoneal area, taking a medial path as they enter anteriorly over the common iliac arteries and passing behind the gonadal vessels before reaching the bladder base in the pelvic region. In males, the ureter runs inward to the medial umbilical ligament and goes behind the vas deferens; in females, the ureter's proximity to the uterine artery at the ureterovesical junction poses a risk of harm during gynecological procedures.
Robotic Approach
Abdominal sacrocolpopexy (ASC) is regarded as the optimum solution for addressing apical vaginal prolapse, demonstrating long-lasting success rates between 68% and 100% [7]. Additionally, an abdominal technique permits the concurrent repair of defects in all three compartments of the pelvic floor: anterior, apical, and posterior, while maintaining vaginal structure. The robotic or laparoscopic method offers a substitute to traditional open surgery, providing similar results and catering to patients who benefit from the established advantages of minimally invasive techniques. The features of this fully minimally invasive surgery, along with its potential positive impact on sexual health (such as maintaining vaginal length and orientation and reducing cases of dyspareunia), render this procedure particularly appealing for younger women who are sexually active. Laparoscopic sacrocolpopexy and sacrohysteropexy is a complex procedure that has a significant learning curve, leading to fewer surgeons adopting this technique more broadly. Robot-assisted sacrocolpopexy (RSC) assists in addressing challenges faced during laparoscopic sacrocolpopexy (LSC) by enhancing deep dissection and suturing capabilities. RSC proves to be a safe and effective choice for individuals suffering from pelvic organ prolapse (POP). It provides numerous advantages, which include a high rate of anatomical cures, enhancements in sexual function, a decrease in perioperative complications, and a minimal chance of recurrence. Furthermore, it emerges as a safe alternative for senior patients. The introduction of robotic/laparoscopic pectopexy in 2011 showcased it as a viable, secure, and easier alternative for surgeries addressing apical prolapse. Pectopexy also has benefits when compared to sacrocolpopexy, especially in the context of patients with obesity. In sacrocolpopexy, there are critical anatomical structures such as the right ureter, hypogastric nerves, middle sacral vessels, and the left common iliac vein located near the sacral promontory. In obese patients, retroperitoneal dissection to prepare the anterior longitudinal ligament and manage the bowel is particularly challenging due to the difficulties in identifying essential landmarks. Obesity compounds surgical difficulty by constraining the surgical environment while trying to balance adequate abdominal pressure and sufficient ventilation. In contrast, pectopexy confines the surgical area to the anterior pelvic space, making it less affected by obesity. Several studies have assessed the clinical effectiveness of pectopexy against sacrocolpopexy, demonstrating its superior efficacy. Since the arrival of the daVinci robotic system in urogynaecology in 2005, it has proven to offer significant advantages over traditional laparoscopy. The robotic system enhances manual precision by providing multiple degrees of freedom and eliminates hand tremors. It also delivers superior visualization with its three-dimensional viewing capabilities. Furthermore, it has a more accessible learning curve for those transitioning from laparoscopic or abdominal surgeries to robotics. Robotic sacrocolpopexy and pectopexy are considered safe and yield outcomes comparable to both open and laparoscopic approaches. Their popularity has surged rapidly since the surgical morbidity associated with these techniques is lower than that found in abdominal and sacral dissections. Knot-tying is also more straightforward in robotic procedures compared to laparoscopic techniques, primarily due to the advantages of three-dimensional visualization.
Evaluation
The approach to managing ureteral injuries resulting from endoscopic procedures differs depending on the severity of the injury [1]. In cases of perforated distal ureters, the optimal treatment involves the placement of a ureteral stent, which is generally removed after a period of 4 to 6 weeks. A urethral Foley catheter may be used temporarily to prevent urine from the bladder refluxing into the ureter, thus promoting maximum healing. Complete avulsions of the ureter necessitate surgical exploration and subsequent repair. The assessment of a potential ureteral injury usually takes place during the operation; therefore, the visibility of the pelvic ureter is restricted by the initial exposure obtained for the main procedure. When a urological surgeon examines a potential pelvic ureteral injury, they may utilize a cystoscope in conjunction with a retrograde pyelogram if direct access to the pelvic ureter is not feasible due to surgical exposure limitations. The intravenous use of methylene blue can assist in identifying subtle injuries effectively. Likewise, methylene blue can be administered via cystoscopy through retrograde methods by using ureteral catheterization. If intraoperative imaging indicates a potential injury, or if fluoroscopy is unavailable, the surgical incision is either enlarged or an additional incision is made to allow for sufficient mobilization and direct observation of the ureter. The segment of ureter under examination should be assessed for tissue viability, which can be determined by the appearance of the ureteral tissue, any urine leakage, and the extent of the disruption or injury. It is essential to inquire about the cause of the injury, as thermal injuries may necessitate debridement beyond the visible area of damage. Other frequent causes of injury include sharp trauma or transection, crush injuries, sutural ligation, and the use of stapling or clipping devices on the ureter. Prior to surgery, careful evaluation of the patient's imaging is crucial to recognize anatomical variations such as solitary kidneys or duplicated ureters.
The ureter comprises two tubular structures responsible for transporting urine from the kidneys to the bladder. Similar to most components of the urinary system, the ureter serves solely a conducting function. This indicates that its sole purpose is to channel urine, without affecting the urine's volume or its composition. The ureter begins within the renal pelvis, descends through the retroperitoneal area situated in the abdominal cavity, and reaches the small pelvis. The terminus of the ureter, which empties into the urinary bladder, is found in the small pelvis.
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Dear Dr. Jessica Magne, Editorial Coordinator 0f Clinical Cardiology and Cardiovascular Interventions, I hope this message finds you well. I want to express my utmost gratitude for your excellent work and for the dedication and speed in the publication process of my article titled "Navigating Innovation: Qualitative Insights on Using Technology for Health Education in Acute Coronary Syndrome Patients." I am very satisfied with the peer review process, the support from the editorial office, and the quality of the journal. I hope we can maintain our scientific relationship in the long term.
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Dear Dr. Jessica Magne, Editorial Coordinator 0f Clinical Cardiology and Cardiovascular Interventions, The review process for the article “The Handling of Anti-aggregants and Anticoagulants in the Oncologic Heart Patient Submitted to Surgery” was extremely rigorous and detailed. From the initial submission to the final acceptance, the editorial team at the “Journal of Clinical Cardiology and Cardiovascular Interventions” demonstrated a high level of professionalism and dedication. The reviewers provided constructive and detailed feedback, which was essential for improving the quality of our work. Communication was always clear and efficient, ensuring that all our questions were promptly addressed. The quality of the “Journal of Clinical Cardiology and Cardiovascular Interventions” is undeniable. It is a peer-reviewed, open-access publication dedicated exclusively to disseminating high-quality research in the field of clinical cardiology and cardiovascular interventions. The journal's impact factor is currently under evaluation, and it is indexed in reputable databases, which further reinforces its credibility and relevance in the scientific field. I highly recommend this journal to researchers looking for a reputable platform to publish their studies.
Dear Editorial Coordinator of the Journal of Nutrition and Food Processing! "I would like to thank the Journal of Nutrition and Food Processing for including and publishing my article. The peer review process was very quick, movement and precise. The Editorial Board has done an extremely conscientious job with much help, valuable comments and advices. I find the journal very valuable from a professional point of view, thank you very much for allowing me to be part of it and I would like to participate in the future!”
Dealing with The Journal of Neurology and Neurological Surgery was very smooth and comprehensive. The office staff took time to address my needs and the response from editors and the office was prompt and fair. I certainly hope to publish with this journal again.Their professionalism is apparent and more than satisfactory. Susan Weiner
My Testimonial Covering as fellowing: Lin-Show Chin. The peer reviewers process is quick and effective, the supports from editorial office is excellent, the quality of journal is high. I would like to collabroate with Internatioanl journal of Clinical Case Reports and Reviews.
My experience publishing in Psychology and Mental Health Care was exceptional. The peer review process was rigorous and constructive, with reviewers providing valuable insights that helped enhance the quality of our work. The editorial team was highly supportive and responsive, making the submission process smooth and efficient. The journal's commitment to high standards and academic rigor makes it a respected platform for quality research. I am grateful for the opportunity to publish in such a reputable journal.
My experience publishing in International Journal of Clinical Case Reports and Reviews was exceptional. I Come forth to Provide a Testimonial Covering the Peer Review Process and the editorial office for the Professional and Impartial Evaluation of the Manuscript.
I would like to offer my testimony in the support. I have received through the peer review process and support the editorial office where they are to support young authors like me, encourage them to publish their work in your esteemed journals, and globalize and share knowledge globally. I really appreciate your journal, peer review, and editorial office.
Dear Agrippa Hilda- Editorial Coordinator of Journal of Neuroscience and Neurological Surgery, "The peer review process was very quick and of high quality, which can also be seen in the articles in the journal. The collaboration with the editorial office was very good."
I would like to express my sincere gratitude for the support and efficiency provided by the editorial office throughout the publication process of my article, “Delayed Vulvar Metastases from Rectal Carcinoma: A Case Report.” I greatly appreciate the assistance and guidance I received from your team, which made the entire process smooth and efficient. The peer review process was thorough and constructive, contributing to the overall quality of the final article. I am very grateful for the high level of professionalism and commitment shown by the editorial staff, and I look forward to maintaining a long-term collaboration with the International Journal of Clinical Case Reports and Reviews.
To Dear Erin Aust, I would like to express my heartfelt appreciation for the opportunity to have my work published in this esteemed journal. The entire publication process was smooth and well-organized, and I am extremely satisfied with the final result. The Editorial Team demonstrated the utmost professionalism, providing prompt and insightful feedback throughout the review process. Their clear communication and constructive suggestions were invaluable in enhancing my manuscript, and their meticulous attention to detail and dedication to quality are truly commendable. Additionally, the support from the Editorial Office was exceptional. From the initial submission to the final publication, I was guided through every step of the process with great care and professionalism. The team's responsiveness and assistance made the entire experience both easy and stress-free. I am also deeply impressed by the quality and reputation of the journal. It is an honor to have my research featured in such a respected publication, and I am confident that it will make a meaningful contribution to the field.
"I am grateful for the opportunity of contributing to [International Journal of Clinical Case Reports and Reviews] and for the rigorous review process that enhances the quality of research published in your esteemed journal. I sincerely appreciate the time and effort of your team who have dedicatedly helped me in improvising changes and modifying my manuscript. The insightful comments and constructive feedback provided have been invaluable in refining and strengthening my work".
I thank the ‘Journal of Clinical Research and Reports’ for accepting this article for publication. This is a rigorously peer reviewed journal which is on all major global scientific data bases. I note the review process was prompt, thorough and professionally critical. It gave us an insight into a number of important scientific/statistical issues. The review prompted us to review the relevant literature again and look at the limitations of the study. The peer reviewers were open, clear in the instructions and the editorial team was very prompt in their communication. This journal certainly publishes quality research articles. I would recommend the journal for any future publications.
Dear Jessica Magne, with gratitude for the joint work. Fast process of receiving and processing the submitted scientific materials in “Clinical Cardiology and Cardiovascular Interventions”. High level of competence of the editors with clear and correct recommendations and ideas for enriching the article.
We found the peer review process quick and positive in its input. The support from the editorial officer has been very agile, always with the intention of improving the article and taking into account our subsequent corrections.
My article, titled 'No Way Out of the Smartphone Epidemic Without Considering the Insights of Brain Research,' has been republished in the International Journal of Clinical Case Reports and Reviews. The review process was seamless and professional, with the editors being both friendly and supportive. I am deeply grateful for their efforts.
To Dear Erin Aust – Editorial Coordinator of Journal of General Medicine and Clinical Practice! I declare that I am absolutely satisfied with your work carried out with great competence in following the manuscript during the various stages from its receipt, during the revision process to the final acceptance for publication. Thank Prof. Elvira Farina
Dear Jessica, and the super professional team of the ‘Clinical Cardiology and Cardiovascular Interventions’ I am sincerely grateful to the coordinated work of the journal team for the no problem with the submission of my manuscript: “Cardiometabolic Disorders in A Pregnant Woman with Severe Preeclampsia on the Background of Morbid Obesity (Case Report).” The review process by 5 experts was fast, and the comments were professional, which made it more specific and academic, and the process of publication and presentation of the article was excellent. I recommend that my colleagues publish articles in this journal, and I am interested in further scientific cooperation. Sincerely and best wishes, Dr. Oleg Golyanovskiy.
Dear Ashley Rosa, Editorial Coordinator of the journal - Psychology and Mental Health Care. " The process of obtaining publication of my article in the Psychology and Mental Health Journal was positive in all areas. The peer review process resulted in a number of valuable comments, the editorial process was collaborative and timely, and the quality of this journal has been quickly noticed, resulting in alternative journals contacting me to publish with them." Warm regards, Susan Anne Smith, PhD. Australian Breastfeeding Association.
Dear Jessica Magne, Editorial Coordinator, Clinical Cardiology and Cardiovascular Interventions, Auctores Publishing LLC. I appreciate the journal (JCCI) editorial office support, the entire team leads were always ready to help, not only on technical front but also on thorough process. Also, I should thank dear reviewers’ attention to detail and creative approach to teach me and bring new insights by their comments. Surely, more discussions and introduction of other hemodynamic devices would provide better prevention and management of shock states. Your efforts and dedication in presenting educational materials in this journal are commendable. Best wishes from, Farahnaz Fallahian.
Dear Maria Emerson, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews, Auctores Publishing LLC. I am delighted to have published our manuscript, "Acute Colonic Pseudo-Obstruction (ACPO): A rare but serious complication following caesarean section." I want to thank the editorial team, especially Maria Emerson, for their prompt review of the manuscript, quick responses to queries, and overall support. Yours sincerely Dr. Victor Olagundoye.
Dear Ashley Rosa, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews. Many thanks for publishing this manuscript after I lost confidence the editors were most helpful, more than other journals Best wishes from, Susan Anne Smith, PhD. Australian Breastfeeding Association.
Dear Agrippa Hilda, Editorial Coordinator, Journal of Neuroscience and Neurological Surgery. The entire process including article submission, review, revision, and publication was extremely easy. The journal editor was prompt and helpful, and the reviewers contributed to the quality of the paper. Thank you so much! Eric Nussbaum, MD
Dr Hala Al Shaikh This is to acknowledge that the peer review process for the article ’ A Novel Gnrh1 Gene Mutation in Four Omani Male Siblings, Presentation and Management ’ sent to the International Journal of Clinical Case Reports and Reviews was quick and smooth. The editorial office was prompt with easy communication.
Dear Erin Aust, Editorial Coordinator, Journal of General Medicine and Clinical Practice. We are pleased to share our experience with the “Journal of General Medicine and Clinical Practice”, following the successful publication of our article. The peer review process was thorough and constructive, helping to improve the clarity and quality of the manuscript. We are especially thankful to Ms. Erin Aust, the Editorial Coordinator, for her prompt communication and continuous support throughout the process. Her professionalism ensured a smooth and efficient publication experience. The journal upholds high editorial standards, and we highly recommend it to fellow researchers seeking a credible platform for their work. Best wishes By, Dr. Rakhi Mishra.
Dear Jessica Magne, Editorial Coordinator, Clinical Cardiology and Cardiovascular Interventions, Auctores Publishing LLC. The peer review process of the journal of Clinical Cardiology and Cardiovascular Interventions was excellent and fast, as was the support of the editorial office and the quality of the journal. Kind regards Walter F. Riesen Prof. Dr. Dr. h.c. Walter F. Riesen.
Dear Ashley Rosa, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews, Auctores Publishing LLC. Thank you for publishing our article, Exploring Clozapine's Efficacy in Managing Aggression: A Multiple Single-Case Study in Forensic Psychiatry in the international journal of clinical case reports and reviews. We found the peer review process very professional and efficient. The comments were constructive, and the whole process was efficient. On behalf of the co-authors, I would like to thank you for publishing this article. With regards, Dr. Jelle R. Lettinga.
Dear Clarissa Eric, Editorial Coordinator, Journal of Clinical Case Reports and Studies, I would like to express my deep admiration for the exceptional professionalism demonstrated by your journal. I am thoroughly impressed by the speed of the editorial process, the substantive and insightful reviews, and the meticulous preparation of the manuscript for publication. Additionally, I greatly appreciate the courteous and immediate responses from your editorial office to all my inquiries. Best Regards, Dariusz Ziora
Dear Chrystine Mejia, Editorial Coordinator, Journal of Neurodegeneration and Neurorehabilitation, Auctores Publishing LLC, We would like to thank the editorial team for the smooth and high-quality communication leading up to the publication of our article in the Journal of Neurodegeneration and Neurorehabilitation. The reviewers have extensive knowledge in the field, and their relevant questions helped to add value to our publication. Kind regards, Dr. Ravi Shrivastava.
Dear Clarissa Eric, Editorial Coordinator, Journal of Clinical Case Reports and Studies, Auctores Publishing LLC, USA Office: +1-(302)-520-2644. I would like to express my sincere appreciation for the efficient and professional handling of my case report by the ‘Journal of Clinical Case Reports and Studies’. The peer review process was not only fast but also highly constructive—the reviewers’ comments were clear, relevant, and greatly helped me improve the quality and clarity of my manuscript. I also received excellent support from the editorial office throughout the process. Communication was smooth and timely, and I felt well guided at every stage, from submission to publication. The overall quality and rigor of the journal are truly commendable. I am pleased to have published my work with Journal of Clinical Case Reports and Studies, and I look forward to future opportunities for collaboration. Sincerely, Aline Tollet, UCLouvain.
Dear Ms. Mayra Duenas, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews. “The International Journal of Clinical Case Reports and Reviews represented the “ideal house” to share with the research community a first experience with the use of the Simeox device for speech rehabilitation. High scientific reputation and attractive website communication were first determinants for the selection of this Journal, and the following submission process exceeded expectations: fast but highly professional peer review, great support by the editorial office, elegant graphic layout. Exactly what a dynamic research team - also composed by allied professionals - needs!" From, Chiara Beccaluva, PT - Italy.
Dear Maria Emerson, Editorial Coordinator, we have deeply appreciated the professionalism demonstrated by the International Journal of Clinical Case Reports and Reviews. The reviewers have extensive knowledge of our field and have been very efficient and fast in supporting the process. I am really looking forward to further collaboration. Thanks. Best regards, Dr. Claudio Ligresti
Dear Chrystine Mejia, Editorial Coordinator, Journal of Neurodegeneration and Neurorehabilitation. “The peer review process was efficient and constructive, and the editorial office provided excellent communication and support throughout. The journal ensures scientific rigor and high editorial standards, while also offering a smooth and timely publication process. We sincerely appreciate the work of the editorial team in facilitating the dissemination of innovative approaches such as the Bonori Method.” Best regards, Dr. Matteo Bonori.
I recommend without hesitation submitting relevant papers on medical decision making to the International Journal of Clinical Case Reports and Reviews. I am very grateful to the editorial staff. Maria Emerson was a pleasure to communicate with. The time from submission to publication was an extremely short 3 weeks. The editorial staff submitted the paper to three reviewers. Two of the reviewers commented positively on the value of publishing the paper. The editorial staff quickly recognized the third reviewer’s comments as an unjust attempt to reject the paper. I revised the paper as recommended by the first two reviewers.
Dear Maria Emerson, Editorial Coordinator, Journal of Clinical Research and Reports. Thank you for publishing our case report: "Clinical Case of Effective Fetal Stem Cells Treatment in a Patient with Autism Spectrum Disorder" within the "Journal of Clinical Research and Reports" being submitted by the team of EmCell doctors from Kyiv, Ukraine. We much appreciate a professional and transparent peer-review process from Auctores. All research Doctors are so grateful to your Editorial Office and Auctores Publishing support! I amiably wish our article publication maintained a top quality of your International Scientific Journal. My best wishes for a prosperity of the Journal of Clinical Research and Reports. Hope our scientific relationship and cooperation will remain long lasting. Thank you very much indeed. Kind regards, Dr. Andriy Sinelnyk Cell Therapy Center EmCell
Dear Editorial Team, Clinical Cardiology and Cardiovascular Interventions. It was truly a rewarding experience to work with the journal “Clinical Cardiology and Cardiovascular Interventions”. The peer review process was insightful and encouraging, helping us refine our work to a higher standard. The editorial office offered exceptional support with prompt and thoughtful communication. I highly value the journal’s role in promoting scientific advancement and am honored to be part of it. Best regards, Meng-Jou Lee, MD, Department of Anesthesiology, National Taiwan University Hospital.
Dear Editorial Team, Journal-Clinical Cardiology and Cardiovascular Interventions, “Publishing my article with Clinical Cardiology and Cardiovascular Interventions has been a highly positive experience. The peer-review process was rigorous yet supportive, offering valuable feedback that strengthened my work. The editorial team demonstrated exceptional professionalism, prompt communication, and a genuine commitment to maintaining the highest scientific standards. I am very pleased with the publication quality and proud to be associated with such a reputable journal.” Warm regards, Dr. Mahmoud Kamal Moustafa Ahmed
Dear Maria Emerson, Editorial Coordinator of ‘International Journal of Clinical Case Reports and Reviews’, I appreciate the opportunity to publish my article with your journal. The editorial office provided clear communication during the submission and review process, and I found the overall experience professional and constructive. Best regards, Elena Salvatore.
Dear Mayra Duenas, Editorial Coordinator of ‘International Journal of Clinical Case Reports and Reviews Herewith I confirm an optimal peer review process and a great support of the editorial office of the present journal
Dear Editorial Team, Clinical Cardiology and Cardiovascular Interventions. I am really grateful for the peers review; their feedback gave me the opportunity to reflect on the message and impact of my work and to ameliorate the article. The editors did a great job in addition by encouraging me to continue with the process of publishing.
Dear Cecilia Lilly, Editorial Coordinator, Endocrinology and Disorders, Thank you so much for your quick response regarding reviewing and all process till publishing our manuscript entitled: Prevalence of Pre-Diabetes and its Associated Risk Factors Among Nile College Students, Sudan. Best regards, Dr Mamoun Magzoub.
International Journal of Clinical Case Reports and Reviews is a high quality journal that has a clear and concise submission process. The peer review process was comprehensive and constructive. Support from the editorial office was excellent, since the administrative staff were responsive. The journal provides a fast and timely publication timeline.
Dear Maria Emerson, Editorial Coordinator of International Journal of Clinical Case Reports and Reviews, What distinguishes International Journal of Clinical Case Report and Review is not only the scientific rigor of its publications, but the intellectual climate in which research is evaluated. The submission process is refreshingly free of unnecessary formal barriers and bureaucratic rituals that often complicate academic publishing without adding real value. The peer-review system is demanding yet constructive, guided by genuine scientific dialogue rather than hierarchical or authoritarian attitudes. Reviewers act as collaborators in improving the manuscript, not as gatekeepers imposing arbitrary standards. This journal offers a rare balance: high methodological standards combined with a respectful, transparent, and supportive editorial approach. In an era where publishing can feel more burdensome than research itself, this platform restores the original purpose of peer review — to refine ideas, not to obstruct them Prof. Perlat Kapisyzi, FCCP PULMONOLOGIST AND THORACIC IMAGING.
Dear Grace Pierce, International Journal of Clinical Case Reports and Reviews I appreciate the opportunity to review for Auctore Journal, as the overall editorial process was smooth, transparent and professionally managed. This journal maintains high scientific standards and ensures timely communications with authors, which is truly commendable. I would like to express my special thanks to editor Grace Pierce for his constant guidance, promt responses, and supportive coordination throughout the review process. I am also greatful to Eleanor Bailey from the finance department for her clear communication and efficient handling of all administrative matters. Overall, my experience with Auctore Journal has been highly positive and rewarding. Best regards, Sabita sinha
Dear Mayra Duenas, Editorial Coordinator of the journal IJCCR, I write here a little on my experience as an author submitting to the International Journal of Clinical Case Reports and Reviews (IJCCR). This was my first submission to IJCCR and my manuscript was inherently an outsider’s effort. It attempted to broadly identify and then make some sense of life’s under-appreciated mysteries. I initially had responded to a request for possible submissions. I then contacted IJCCR with a tentative topic for a manuscript. They quickly got back with an approval for the submission, but with a particular requirement that it be medically relevant. I then put together a manuscript and submitted it. After the usual back-and-forth over forms and formality, the manuscript was sent off for reviews. Within 2 weeks I got back 4 reviews which were both helpful and also surprising. Surprising in that the topic was somewhat foreign to medical literature. My subsequent updates in response to the reviewer comments went smoothly and in short order I had a series of proofs to evaluate. All in all, the whole publication process seemed outstanding. It was both helpful in terms of the paper’s content and also in terms of its efficient and friendly communications. Thank you all very much. Sincerely, Ted Christopher, Rochester, NY.
