This is the case of a 37 years old woman presenting with a (10 cm × 6 cm) heterogenous right ovarian swelling and a history of having had previous four caesarean sections with dense pelvic adhesions. The patient was listed for exploratory laparotomy and right adnexectomy. Prophylactic bilateral ureteric catheters were inserted via cystoscopy prior to the start of the surgical procedure to reduce the risk of iatrogenic ureteral injury. The operation was completed uneventfully. In the immediate postoperative period the patient complained of severe suprapubic pain and haematuria and the ureteral catheters were removed with improvement of he symptoms though the haematuria persisted. During the 1st postoperative day, it was noted that the urine output, vital signs and laboratory investigations were within normal range. On day 2 postoperative the patient complained of severe bilateral flank pain, oliguria and haematuria. Despite intravenous fluid challenge the urine output remained minimal up to anuria (urine output of 150 cc in 12 h). Kidney function tests revealed progressive rise in serum creatinine and urea levels (296 uml/l (N: 53–97) and 7.7 mmol/l (N: 2.5–6.7) respectively. A CT scan abdomen and pelvis showed bilateral hydronephrosis and hydroureter down to the level of the urinary bladder with no evidence of obstruction in the course of the ureters. Chest X-ray revealed signs of pulmonary congestion. The patient was given 80 mg intravenous diuretic (Lasix) and was consented for ureteric recatheterization aiming to relieve the obstruction in case of failure of the conservative medical management. Surprisingly, the patient responded dramatically to the diuretic injection with improvement in the urine output and progressive decrease in serum creatinine and urea levels down to normal values within 24 h. The haematuria cleared out within the next few days. Follow up renal scans revealed gradual improvement in the hydronephrosis and hydroureter. Conclusion: It was published in series report that the incidence of obstructive anuria after ureteral catheter removal varies from 0 to 7.6% (1). So, the safety of prophylactic preoperative bilateral ureteric catheterization to reduce ureteric injury has been questioned due to reports of this rare but serious phenomenon of reflux anuria. Till now there are no proven strategies for prevention of this condition but staged removal has shown trend towards reduced incidence (2). When encountered most cases resolved with conservative management only. However, indwelling recatheterization has been advocated as an emergency management while oedema resolves. Additionally, in our case, the use of diuretic might have expedited recovery.