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?
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?
A bladder catheter that’s inserted during the procedure is usually left in place for a few days after surgery. This is done to ensure that urine continues to drain as the re-implanted ureter heals. Because the surgery involves a small incision, it usually heals fairly quickly. Children who have re-implant surgery may be given a nerve block injection to minimize discomfort when waking up from the anesthesia.
Some patients are given a patient-controlled analgesia (PCA) pump. A PCA pump delivers medication at a slow and steady pace via an intravenous (IV) line. Over-the-counter pain medications may also be recommended. A follow-up visit with a urologist typically involves an ultrasound to ensure that the repositioned ureter is functioning as expected and that there isn’t any urine blockage. A voiding cystourethrogram that involves the use of a special type of X-ray and a lighted scope is sometimes done to view the urinary tract and bladder.
Are There Any Potential Issues with Urination After Surgery?
Some children who have the procedure may have lingering issues with urination. Such difficulties may include frequent urination, bladder spasms, or urine leaks before being able to reach a bathroom. A urologist may prescribe medication to improve comfort. Warm baths may also be helpful. Issues with urination usually go away after the bladder heals from the re-implant procedure. Until this happens, padded underwear may reduce the risk of having embarrassing moments with urine leakage.
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. If UTIs occur on a regular basis, a urologist can perform an examination to determine the reason and recommend an appropriate treatment.