Ureteral reimplantation (yoor-EET-er-ool RE-im-plan-TAY-shun) is used to treat reflux (REE-flux), a condition in which urine from the bladder is able to flow back up into the kidneys through the tubes that connect the kidneys with the bladder.

When these tubes, called the ureters (YOOR-et-ers), are working properly, urine flows only one way out through them from the kidneys and into the bladder so that it can leave the body. The ureters connect to the bladder through a tunnel that acts as a valve to keep urine from flowing backward.

Sometimes, a ureter has a bad connection to the bladder wall. When there is not enough of the tunnel at the connection point, reflux will occur. If left untreated, reflux can cause scarring of the kidneys and permanent kidney damage.

When reflux is not expected to go away with time, or is causing kidney damage, surgery is needed.

Surgery to correct reflux consists of changing the way the ureter connects to the bladder by creating a new tunnel into the bladder. The doctor “reimplants” the ureter to fix its connection to the bladder.

• Recurrent Urinary Tract Infections (UTIs): Frequent infections, particularly in children, often due to VUR.
• Flank or Abdominal Pain: Persistent pain in the back or sides that may be related to kidney issues.
• Fever and Chills: Symptoms associated with infections stemming from reflux or obstruction.
• Difficulty Urinating: Symptoms like pain or difficulty starting urination.
• Blood in Urine (Hematuria): Presence of blood in the urine, which can indicate underlying issues.
• Kidney Dysfunction: Symptoms like high blood pressure or abnormal kidney function tests due to kidney damage from reflux.

• Imaging Studies: Includes ultrasound, voiding cystourethrogram (VCUG), or renal scan to assess the condition of the ureters and bladder.
• Preparation: Fasting and possibly adjusting medications before the procedure.

• Anesthesia: The procedure is performed under general anesthesia.
• Incisions: Depending on the approach, incisions may be made in the abdomen or a minimally invasive laparoscopic approach may be used.

• Identification: The affected ureter(s) are identified and mobilized.
• Reimplantation: The ureter is reattached to the bladder in a new position to correct the reflux or obstruction. This may involve creating a new tunnel within the bladder for the ureter to prevent reflux.
• Closure: The incisions are closed with sutures or staples.

• Hospital Stay: Typically, patients stay in the hospital for 1-3 days, depending on the complexity of the procedure and recovery.
• Pain Management: Pain is managed with medications, and patients are monitored for any signs of complications.
• Catheterization: A urinary catheter or stent may be placed temporarily to aid in urine drainage and healing.
• Activity Restrictions: Avoid heavy lifting and strenuous activities for a few weeks.
• Follow-Up: Regular follow-up visits are necessary to monitor recovery, assess kidney and bladder function, and remove any temporary stents or catheters.

• Infection: Risk of postoperative infections, including urinary tract infections or wound infections.
• Bleeding: Potential for bleeding during or after the procedure.
• Injury to Surrounding Structures: Risk of damage to nearby organs or tissues.
• Urinary Leakage: Possible leakage of urine from the ureter or bladder.
• Recurrent Reflux or Obstruction: Possibility that the original problem may persist or recur, requiring further treatment.

• Effective Treatment: Can significantly reduce or eliminate symptoms of VUR or obstruction and prevent kidney damage.
• Improved Kidney Function: Helps in preserving kidney function by correcting the abnormal urine flow.
• Reduced Risk of Complications: Reduces the risk of recurrent UTIs and kidney damage compared to untreated VUR.