Laparoscopic Ureteral Reimplantation

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Definition

Laparoscopic 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.

Laparoscopic procedures use small incisions and specialized tools. This helps to avoid large incisions that are needed with open surgery.

The Urinary Tract

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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 causing urine to flow back into the ureters and kidneys—vesicoureteral reflux
  • Were damaged due to trauma or surgery

Possible Complications    TOP

Problems from the test are rare. However, all procedures have some risk. Your doctor will review potential problems, like:

  • Excess bleeding
  • Adverse reaction to anesthesia
  • Infection
  • Soreness in throat
  • Nausea and vomiting
  • Bladder spasms
  • Cramping
  • Difficulty urinating

Talk to the doctor about these risks before the procedure.

What to Expect    TOP

Prior to Procedure

  • The doctor may take images of urinary tract.
  • Blood and urine tests may be done. These tests 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 an IV. 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

A few small incisions will be made in your abdomen. Specialized tools will be inserted through the incisions. A series of incisions and stitches will be used to realign the ureter. The method used will be based on your specific condition.

After the tools are removed, the incisions in the abdomen will be closed with stitches. Bandages may be placed over the incisions.

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. You will be given medication to help manage any discomfort.

Average Hospital Stay    TOP

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

Post-procedure Care    TOP

At the Hospital

  • You will receive fluids and medications through an IV.
  • Urine will drain through the tube into a bag. The urine may have blood in it for the first few days.

At Home

Certain physical activities will be limited in the first few weeks such as heavy lifting or sexual activity.

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 were given
  • Persistent nausea or vomiting

If you think you have an emergency, call for emergency medical services right away.

RESOURCES:

National Institute of Diabetes and Digestive and Kidney Diseases
https://www.niddk.nih.gov
Urology Care Foundation
http://urologyhealth.org

CANADIAN RESOURCES:

Canadian Urological Association
http://www.cua.org

References:

Ureteral reimplant. Children’s Hospitals and Clinics of Minnesota website. Available at: https://www.childrensmn.org/references/pfs/surg/ureteral-reimplant.pdf. Updated October 2013. Accessed March 7, 2018.
Ureteral reimplant surgery FAQ. UCSF Benioff Children’s Hospital website. Available at: https://www.ucsfbenioffchildrens.org/education/ureteral_reimplant_surgery/index.html. Accessed March 7, 2018.
Ureteral reimplantation surgery. Children’s Hospital of Pittsburgh website. Available at:
...(Click grey area to select URL)
Accessed March 7, 2018.
Vesicoureteral reflux. EBSCO DynaMed Plus website. Available at: http://www.dynamed.... Updated October 2, 2017. Accessed March 7, 2018.
Vesicoureteral reflux. National Institute of Diabetes and Digestive and Kidney Diseases website. Available at:
...(Click grey area to select URL)
Updated June 2012. Accessed March 7, 2018.
Last reviewed March 2018 by EBSCO Medical Review Board Adrienne Carmack, MD
Last Updated: 4/29/2014

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