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Laparoscopic Ureteral Reimplantation

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

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—known as vesicoureteral reflux (VUR)
  • Were damaged due to trauma or surgery

Possible Complications

If you are having this procedure, the doctor will review a list of possible complications. These may include:

  • 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

Prior to Procedure

  • The doctor may need pictures of your urinary tract.
  • Blood and urine tests may be done. Theses 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 medicines 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

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

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

How Long Will It Take?

2 to 3 hours

How Much Will It Hurt?

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

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

Post-procedure Care

At the Hospital
  • You will receive fluids and medicines 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

When you return home, be sure to follow your doctor's instructions.

Call Your Doctor

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 the doctor prescribed
  • Nausea and/or vomiting that you cannot control with the medications the doctor prescribed

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

Revision Information

  • American Urological Association

    http://www.auanet.org

  • Healthy Children—American Academy of Pediatrics

    http://www.healthychildren.org

  • Canadian Urological Association

    http://www.cua.org

  • Health Canada

    http://www.hc-sc.gc.ca

  • Ureteral reimplant surgery FAQ. UCSF Benioff Children’s Hospital website. Available at: http://www.ucsfbenioffchildrens.org/education/ureteral%5Freimplant%5Fsurgery/index.html. Accessed January 12, 2015.

  • Ureteral reimplant. Children’s Hospitals and Clinics of Minnesota website. Available at: http://www.childrensmn.org/manuals/pfs/surg/018768.pdf. Updated October 2013. Accessed January 12, 2015.

  • Ureteral reimplantation. Children’s Hospital of Wisconsin website. Available at: http://www.chw.org/display/PPF/DocID/48560/router.asp. Accessed January 12, 2015.

  • Ureteral reimplantation surgery. Children’s Hospital of Pittsburgh website. Available at: http://www.chp.edu/CHP/Ureteral+Reimplantation+Surgery. Accessed January 12, 2015.

  • Vesicoureteral reflux. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated December 28, 2014. Accessed January 12, 2015.

  • Vesicoureteral reflux. National Kidney and Urologic Diseases Information Clearinghouse website. Available at: http://kidney.niddk.nih.gov/kudiseases/pubs/vesicoureteralreflux. Updated June 29, 2012. Accessed January 12, 2015.