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Open Ureteral Reimplantation

(Open Ureterectomy with Reimplantation)
  • Definition

    Ureteral reimplantation is surgery to reposition a ureter. The ureter is a tube between the kidney and the bladder. It allows urine to pass down to the bladder.
    The Urinary Tract
    IMAGE
    Copyright © Nucleus Medical Media, Inc.
  • Reasons for Procedure

    Some ureters are not positioned correctly in the bladder. This can make it difficult for urine to flow into the bladder. Ureteral reimplantation may be done to reposition ureters that:
    • Are causing urine to flow back into the ureters and kidneys—known as vesicoureteral reflux (VUR)
    • Were damaged due to trauma or surgery
  • Possible Complications

    If you are having this procedure, the doctor will review a list of possible complications. These may include:
    • Excess bleeding
    • Adverse reaction to anesthesia, including, light-headedness, low blood pressure, and wheezing
    • Infection
    • Soreness in throat
    • Nausea and vomiting
    • Bladder spasms
    • Cramping
    • Difficulty urinating
    Talk to the doctor about these risks before the procedure.
  • What to Expect

    Prior to Procedure
    • The doctor may need pictures of your urinary tract.
    • Blood and urine tests may be done. Theses test will show how well the kidneys are working.
    • Talk to the doctor about any medications you are taking:
      • Do not take any new medications, herbs, or supplements without talking to the doctor.
      • You may be asked to stop taking some medicines up to 1 week before the procedure.
    • Arrange for a ride home from the hospital.
    • The night before surgery, you should eat a light meal. You should not eat or drink anything after midnight unless told otherwise by the doctor.
    Anesthesia
    General anesthesia may be used. It will be given through a vein in the arm or hand. You will be asleep through the procedure.
    A spinal block may be used. This is an anesthesia injected into the spine. It will block pain below your waist.
    Description of the Procedure
    An incision will be made in the abdomen. A series of incisions and stitches will be used to realign the ureter. The method chosen will be based on your specific condition. The incision in the abdomen will be closed with dissolvable stitches. A bandage will be placed over the incision.
    A tube will be placed into the bladder. This will allow urine to drain while your bladder heals.
    Immediately After Procedure
    After the operation, you will be taken to the recovery room for observation.
    How Long Will It Take?
    2 to 3 hours
    How Much Will It Hurt?
    Anesthesia prevents pain during surgery. There may be some pain as you recover. You may also have some cramping in your bladder. The doctor will give you medication to help manage any discomfort.
    Average Hospital Stay
    The usual length of stay is 2 to 4 days. You may need to stay longer if there are any complications.
    Post-procedure Care
    At the Hospital
    • You will receive fluids and medications through an IV.
    • Urine will drain through the tube and into a bag. The urine may have blood in it for the first few days.
    • After surgery, images will be taken to make sure the ureter is in the correct place.
    At Home
    When you return home, be sure to follow your doctor's instructions.
  • Call Your Doctor

    Call your doctor if any of these occur:
    • Difficulty urinating
    • Excess bleeding
    • Signs of infection, including fever and chills
    • Pus or bad smelling fluids draining from the incision site
    • Redness or swelling at the incision site
    • Urine that smells bad
    • Pain that cannot be controlled with the medications you have been given
    • Nausea and/or vomiting that you cannot control with the medications you have been given
    If you think you are having an emergency, call for emergency medical services right away.
  • RESOURCES

    American Urological Association http://www.auanet.org

    National Kidney and Urologic Diseases Information Clearinghouse http://www.kidney.niddk.nih.gov

    CANADIAN RESOURCES

    Canadian Urological Association http://www.cua.org

    Health Canada http://www.hc-sc.gc.ca

    References

    Ureteral reimplant surgery FAQ. UCSF Benioff Children’s Hospital website. Available at: http://www.ucsfbenioffchildrens.org/education/ureteral%5Freimplant%5Fsurgery/index.html. Accessed January 12, 2015.

    Ureteral reimplant. Children’s Hospitals and Clinics of Minnesota website. Available at: http://www.childrensmn.org/manuals/pfs/surg/018768.pdf. Updated October 2013. Accessed January 12, 2015.

    Ureteral reimplantation. Children’s Hospital of Wisconsin website. Available at: http://www.chw.org/display/PPF/DocID/48560/router.asp. Accessed January 12, 2015.

    Ureteral reimplantation surgery. Children’s Hospital of Pittsburgh website. Available at: http://www.chp.edu/CHP/Ureteral+Reimplantation+Surgery. Accessed January 12, 2015.

    Vesicoureteral reflux. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed . Updated December 28, 2014. Accessed January 12, 2015.

    Vesicoureteral reflux. National Kidney and Urologic Diseases Information Clearinghouse website. Available at: http://kidney.niddk.nih.gov/kudiseases/pubs/vesicoureteralreflux. Updated June 29, 2012. Accessed January 12, 2015.

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