Objective Iatrogenic ureteral injury during gynaecological surgery is associated with increased morbidity when not diagnosed during the initial surgery. Preoperative insertion of ureteral catheters may enhance intraoperative recognition of injury and repair, but it is controversial. We sought to analyze the costs of this approach. ureteral catheterization should be considered for cost savings in women undergoing benign abdominal or radical hysterectomy in whom the risk of ureteral injury exceeds 3%. We believe that each surgeon should assess his or her personal ureteral injury rate and plan for ureteral catheterization accordingly. Universal ureteral catheterization is cost saving when the rate of ureteral injury during benign abdominal hysterectomy or radical hysterectomy is greater than 4%.