Ureter reconstruction is sometimes needed when a ureter has been damaged by disease or surgery.
The ureters are the 8- to 10-inch tubes that transport urine from the kidneys to the bladder. Each ureter is surrounded by muscles that tighten and relax to propel urine into the bladder as needed. When a ureter is damaged, urine can’t flow properly and backs up in the kidney. This can lead to urinary tract and kidney infections, as well as kidney damage.
Some causes of ureter damage include:
- Injury during pelvic or colorectal surgery
- Scarring from endoscopic kidney stone removal procedures
- Cancers of the urinary tract
- Inflammatory disorders
A variety of reconstruction procedures can be used to repair a damaged ureter, ranging from simple outpatient procedures with a short recovery time to major abdominal repairs that require lengthy hospitalization. The type of procedure chosen for a patient will depend on the location and nature of the injury and any complicating factors or medical conditions.
What Are the Benefits of Ureter Reconstruction?
A ureter injury can not only lead to kidney damage but also can greatly affect an individual’s quality of life. In some cases, a nephrostomy tube is inserted into the patient’s lower back and connected to the kidney so urine can drain into a bag that must remain attached to the patient’s body at all times. Ureter reconstruction can return normal urinary function and remove lifestyle limitations.
Ureter Reconstruction Details
There are many different options for major ureter reconstruction, including:
- Ureter reimplantation – The damaged ureter is reattached to the bladder in a new location (for lower ureter problems).
- Psoas hitch/Boari flap repair – A portion of the damaged ureter is removed and the bladder is repositioned to close the gap.
- End-to-end repair – The damaged portion of the ureter is removed and the two cut ends are sewn together.
- Ileal ureter – A section of the small bowel is used to replace a longer segment of the damaged ureter.
What to Expect With Ureter Reconstruction
All of these procedures will require a hospital stay, and drains will likely be placed in any incisions to help with fluid buildup. A catheter will also be placed in the bladder during the healing process.
How Effective Is Ureter Reconstruction?
Ureter reconstruction has an extremely high success rate, and most patients regain normal urinary function once the recovery process is complete.
Tampa General Hospital is the first hospital in Florida to offer the most advanced robotic technology for urologic procedures, including ureter reconstruction. Robotic-assisted surgery involves cutting just one small incision to allow for a faster and less painful recovery.