Ureteral Reimplantation Surgery

Ureteral reimplantation is a surgical procedure performed to correct abnormalities in the insertion of the ureter into the bladder, which can lead to a condition called vesicoureteral reflux (VUR). This condition occurs when the bladder cannot close properly, causing urine to flow back into the ureters or even the kidneys. VUR is most commonly seen in infants and young adults and, if left untreated, can lead to urinary infections and kidney damage.

Alternate Name of Ureteral Reimplantation Surgery:

Ureteroneocystostomy (UNC)

Body Location:

Ureter

Ureteral Reimplantation Procedure Type:

Surgical

Preparation for Ureteral Reimplantation Surgery:

Pre-operative tests: Your doctor will recommend tests such as ultrasonography, ECG, and blood tests to assess your suitability for surgery.
Admission: The patient is typically admitted one day before the surgery.
Diet before surgery: No solid food after midnight before the surgery, and no liquids within 2 hours of the procedure.

How Ureteral Reimplantation Surgery is Performed:

The procedure takes 2-3 hours under general anesthesia. A small incision is made in the lower abdomen to access the ureter and bladder. The ureter is detached from the bladder, and a new site for reimplantation is determined. A tunnel is created in the bladder for the ureter, which is then secured in place with stitches. If the other ureter also requires treatment, it will be addressed at this time. The bladder is stitched, and the incision is closed using either stitches or surgical tapes. A drain tube may be placed to remove any fluid build-up post-surgery.

Follow-up After Ureteral Reimplantation Surgery:

After surgery, blood pressure, wound, and pulse are monitored regularly. The patient may have a drip for fluid intake and a catheter to assist with urine flow, which might be blood-stained for the first 48 hours. The patient will begin walking once recovered from anesthesia, under careful supervision. Pain medications will be prescribed to manage discomfort. In cases involving children, a parent may stay with the child.

Risks Associated with Ureteral Reimplantation Surgery:

While ureteral reimplantation is generally a safe procedure, some potential risks include:

Blood in the urine
Kidney infection
Leakage of urine around the bladder
Bladder spasms
Blockage of the ureters
Persistent urine reflux despite surgery

Recovery After Ureteral Reimplantation Surgery:

Patients are usually discharged 2-3 days post-surgery. Full recovery may take 1-2 weeks, and strenuous activities should be avoided for 4-6 weeks. A catheter, if used, will be removed about one week after surgery, and a drain, if placed, will be removed after 4-6 weeks. Pain relief medications such as Tylenol or Ditropan may be prescribed, along with antibiotics to promote healing and prevent infections. An ultrasound is usually performed one month after surgery to check for any blockages. A Voiding Cystogram (VCUG) is conducted 4-6 weeks after surgery to ensure the issue of urine reflux is resolved.

Frequently Asked Questions:

What is the success rate of ureteral reimplantation?
- The success rate can vary based on the patient’s condition and health. Consult with a healthcare provider for detailed information.
Can the ureter repair itself?
- Minor injuries or mild obstructions may heal on their own, but significant damage or strictures often require surgical intervention, such as ureteral reimplantation.
Is ureteral reimplantation surgery painful?
- The procedure is performed under general anesthesia, so no pain is felt during surgery. Post-surgery pain can be managed with medications.
What conditions require ureteral reimplantation?
- Conditions such as ureteral obstruction, vesicoureteral reflux (VUR), strictures, trauma, recurrent UTIs, and congenital abnormalities may require this surgery.
What are the different surgical approaches used in ureteral reimplantation?
- Options include open surgery, laparoscopic surgery, and robotic-assisted surgery. The choice depends on the complexity of the case and other factors.
Will I be under general anesthesia during the procedure?
- Yes, general anesthesia is used to ensure the patient is unconscious and free of pain during the procedure.
Will there be scars after ureteral reimplantation?
- Scarring depends on the surgical approach. Open surgery may leave larger scars, while minimally invasive methods like laparoscopic or robotic-assisted surgery result in smaller, less visible scars.
What dietary restrictions are there after ureteral reimplantation?
- Dietary restrictions vary depending on individual circumstances. A balanced diet that supports healing is generally recommended. Always follow your healthcare provider’s instructions.

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