What is the ureteric re-implantation operation and why might my child need it?
As shown in the diagram, the ureters are two tubes which carry urine from the kidneys to the bladder. In some children, the ureters do not join the bladder in the correct place and this can cause a condition called vesicoureteral reflux (VUR). Normally, valves between the ureters and the bladder prevent urine ‘backing up’ and flowing towards the kidneys. If the ureters do not join the bladder in the correct place, these valves can fail, allowing urine to flow backwards from bladder to kidney. This can damage the kidney and eventually lead to kidney failure.
What does the operation involve?
At surgery, an incision (cut) is made in the lower abdomen. The ureters are disconnected from their attachment to the bladder. The ureters are then reattached to the bladder in the correct place. The end of the ureters joining the bladder will then be surrounded by muscle, which will strengthen the valves, reducing the chances of urine flowing back to the kidneys. The operation takes between 1and a half and 2 hours. The usual hospital stay is 5 – 7 days.
Surgery for Ureteric Reimplant
What are the risks of this operation?
The operation risk is minimum. There is sometimes bleeding when the surgeon disconnects the ureters during the operation. This is usually only slight, but if a lot of blood is lost your child may need to be given a blood transfusion.
Are there any alternatives to the operation?
If your child has VUR and needs their valve to be repaired, there is one alternative to surgery. STING is an injection which is given into the valve in the bladder, with the help of cystoscopy (a tube with a camera on the end which is inserted into the bladder). STING is quicker and enables an early discharge from the hospital. More details about the pros and cons and whether your child is suitable for the treatment can be obtained at the time of consultation.
Click here Movies for Deflux Injection
Deflux seen on ultrasound after injection
When you get home
The child should be encouraged to drink lots of water / liquids.
Antibiotics will be given to your child at discharge to be continued for 6 weeks. A regular urine check needs to be done on a monthly basis for 6 months after surgery. We will monitor the postoperative changes with an ultrasound scan and if needed a nuclear scan. Advise regarding the same will be given to you at the time of discharge.
