Ureteral Re-Implant

During this procedure, the ureter is repositioned into its correct place.

Ureters are tubes that normally transport urine from the kidneys to the bladder. In some individuals, a ureter may be abnormally positioned. It’s a condition more likely to occur in children, who are often born with the abnormality.

If a ureter is not positioned correctly, urine may move back up through the affected ureter into the kidney it’s attached to.
This is referred to as a vesicoureteral reflux, and it’s one of the reasons why a urologist may recommend ureteral re-implant surgery.

How is a Ureteral Re-Implant Done?

The ureter is repositioned within the bladder wall

Proper placement helps prevent urine from flowing backward

The procedure is performed through a small abdominal incision

During the procedure, the ureter is repositioned (“re-implanted”) into the correct position in the bladder wall. When in the intended position, the bladder muscle will keep urine from traveling back into the corresponding kidney. Restoring the ureter’s correct position can minimize the risk of developing kidney infections or other types of related damage. The procedure only requires a small incision in the abdomen. It’s through this incision that the affected ureter will be accessed and repositioned. The operation usually takes 2-3 hours to complete.

What Happens After Surgery?

Post-surgical care helps ensure proper healing and urine drainage. Recovery generally focuses on maintaining urine flow while the repositioned ureter heals.

A bladder catheter placed during surgery usually remains in place for several days to allow urine to drain while healing occurs.

Because the surgery involves only a small incision, recovery time is often relatively quick for most patients.

Children undergoing ureteral re-implant surgery may receive a nerve block injection to reduce discomfort after anesthesia.

Follow-Up Care and Monitoring

Some patients may receive a patient-controlled analgesia (PCA) pump for pain management

Over-the-counter pain medications may also be recommended

Follow-up visits often include an ultrasound to check the ureter’s function

A voiding cystourethrogram may be used to examine the bladder and urinary tract

Patients are usually monitored after surgery to confirm that the ureter is functioning correctly and that urine is draining normally.

Possible Urination Issues After Surgery

Some children who have the procedure may temporarily experience changes in urination while the bladder continues to heal.

Frequent urination or bladder spasms may occur

Some children may leak urine before reaching the bathroom

A urologist may prescribe medication to improve comfort

Warm baths and padded underwear may help manage symptoms

Long-Term Outlook

Temporary Symptoms

Issues with urination usually go away after the bladder heals from the re-implant procedure.

Managing Infections

Even when ureteral re-implant is successful, it’s possible for patients to experience occasional urinary tract infections for different reasons. However, such infections are often easier to treat when there isn’t any risk of damage to the kidneys from urine flowing back up via the ureter.

Ongoing Evaluation

If UTIs occur on a regular basis, a urologist can perform an examination to determine the reason and recommend an appropriate treatment.