Ureteric Reimplantation Surgery

What is a Ureteric Reimplant and explain the need of undergoing this procedure?

Ureteral reimplantation is used for the treatment of reflux. It is a condition in which urine from the bladder can flow back through the tubes that connect the kidneys to the bladder. This condition is graded from 1 to 5, with one being very minor and five being very serious. Testing is performed on the basis of the cystogram tests, the x-ray test in which dye is inserted in the bladder, and the ureters and kidneys are observed. Children with reflux are more prone to experience urine problems as well as infections, which can result in kidney scarring and damage. But in more serious cases, the kidney and ureter become inefficient, large, and distorted..

Treatment

Ureteric reimplantation is a procedure to treat reflux in children. It can be one unilateral or both bilateral ureters requiring repair. Several factors can lead to correction of the surgery including:

• The the child has no tolerance for antibiotics.
• Despite being on antibiotics, urinary infections occur.
• Families are opting for surgery as an alternative to other medical treatments.
• The reflux continues over many years without observation.
• The kidneys do not grow normally, or on medical treatment alone start to develop scars.

What goes with Ureteric Reimplantation?

The operation is performed to correct the defective “flap-valve” in which the ureter enters the bladder and thereby prevents reflux. The child is anesthetized, and an incision of a small bikini line is made. Through this, you can approach and open the bladder. The ureter hole is located, and around it is rendered a tiny triangular incision.
The ureter is muscle-free dissected from the bladder.

When the ureter is able to slide freely in and out of the bladder wall, a small tunnel is made by your surgeon for each ureter. It is almost 2 cm long and has the end opening into the bladder. This tunnel is then passed through the ureter and stitched into shape. That is such that the sides of the ureter will be pushed closer in the future, as the bladder muscle contracts to transfer urine, and it will stop running back to the kidney.

The location of the ureter ‘s initial opening is then locked and the bladder is covered, too. A catheter is explained as a flexible drainage tube, which is left in the bladder and exits to drain urine from the bladder through the abdominal wound to allow for healing. All other stitches dissolve apart from the stitch holding the catheter in place and will not need to be removed after the operation.

Then a dressing is placed above the wound to protect the incision and healing aid.Depending on whether one or both ureters are reimplanted, the operation can take from 1-3 hours or usually takes one to two nights in hospital but some kids may go back to their home on the same day.