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Open Ureteral Reimplantation

(Open Ureteroneocystostomy with Reimplantation)

Open Yur-e-t-er-on-e-o-si-tost-o-me with Re-im-plan-tay-shun

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

Copyright © Nucleus Medical Media, Inc.

Reasons for Procedure    TOP

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 allowing urine to flow back into the ureters and kidneys—known as vesicoureteral reflux (VUR)
  • Were damaged due to trauma or surgery

Possible Complications    TOP

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
  • Failure of the operation to correct the problem
  • Excess scarring or narrowing in the ureter that can lead to kidney problems

Talk to the doctor about these risks before the procedure.

What to Expect    TOP

Prior to Procedure

  • The doctor may need pictures of your urinary tract.
  • Blood and urine tests may be done. These 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 medications 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    TOP

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    TOP

After the operation, you will be taken to the recovery room for observation.

How Long Will It Take?    TOP

2 to 3 hours

How Much Will It Hurt?    TOP

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    TOP

The usual length of stay is 2 to 4 days. You may need to stay longer if there are any complications.

Post-procedure Care    TOP

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    TOP

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

References:

Ureteral reimplant surgery FAQ. UCSF Benioff Children’s Hospital website. Available at:
...(Click grey area to select URL)
Accessed March 7, 2016.
Ureteral reimplant. Children’s Hospitals and Clinics of Minnesota website. Available at:
...(Click grey area to select URL)
Updated October 2013. Accessed March 7, 2016.
Ureteral reimplantation surgery. Children’s Hospital of Pittsburgh website. Available at:
...(Click grey area to select URL)
Accessed March 7, 2016.
Vesicoureteral reflux. EBSCO DynaMed website. Available at:
...(Click grey area to select URL)
. Updated August 25, 2015. Accessed March 7, 2016.
Vesicoureteral reflux. National Kidney and Urologic Diseases Information Clearinghouse website. Available at:
...(Click grey area to select URL)
Updated June 2012. Accessed March 7, 2016.
Last reviewed March 2017 by EBSCO Medical Review Board Adrienne Carmack, MD
Last Updated: 4/29/2014

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