Simple Ureteric Reimplantation
Ureters are two narrow tubes that empty urine formed in the kidneys into the bladder, where it is temporarily stored before being released to the outside through the urethra. Injury or obstructions in the ureters can cause the backflow of urine into the kidneys (vesicoureteral reflux) and lead to urinary tract infections or kidney damage. Ureteric reimplantation, also called ureteroneocystostomy, is a procedure that reimplants the ureter in the bladder to treat vesicoureteral reflux.
Laparoscopy
Laparoscopic ureteric excision and reimplantation are performed under general anaesthesia. Your surgeon makes 3 to 4 small incisions in the abdomen and inserts a laparoscope (tube with a light and a small camera attached) to view the abdominal cavity. Surgical instruments are passed through the other incisions. The lower end of the ureter and a section of the bladder are freed from the surrounding tissues and excised. The excised section is placed in a bag and removed. Your surgeon reimplants the remaining length of the ureter in the bladder. The opening in the bladder is closed. A stent (thin tube) may be placed for 4 to 6 weeks to keep the ureter open as it heals. A catheter is placed in the bladder to drain the urine. The incisions are closed with sutures.
Like all surgeries, ureteric reimplantation is associated with certain complications such as bleeding, infection, bladder irritability and inability to urinate.
Open Surgery
Ureteric reimplantation is performed under general anaesthesia. During the procedure, a semi-circular incision is made in the pelvic region. The ureter is carefully detached, a tunnel is created in the muscle layer of the bladder and the ureter is inserted back closer into the bladder. The incision on the pelvic region is sutured with dissolvable stitches. The entire procedure takes approximately 2 to 3 hours to complete. Your doctor may perform renal ultrasonography about 3 months post-operatively, to evaluate for obstruction and success rate.