Ureterotomy

What is it?

  • Opening up of a very narrowed/ obstructed ureteric opening. Either by cold knife or laser.
  • Where a congenital / acquired narrowing in the ureteric opening occurs.
  • This procedure is used to open the ureter and ease the urine flow. It can cause Vescio ureteric reflux.

Why is it done?

  • Congenital narrowing of the ureteric opening in the bladder as per a Ureterocele.
  • Previous bladder surgery where the ureteric orifice was involved: i.e. Bladder tumour resection.
  • Where conservative measures have failed: i.e. Stenting, Dilatation etc.
  • To prevent renal function deterioration.
  • Stenting or nephrostomy placement would have been done in the acute state to relief an obstructed and infected system.

How is it done?

  • Patients will receive a general anesthesia.
  • Prophylactic antibiotics is given.
  • The correct kidney is identified and marked while you are awake.
  • This will be an endoscopic procedure.
  • A cystoscopy will be done with placement of ureteric guidewire.
  • Laser will be used to cut the stricture open.
  • The alternative is using endoscopic scissors (when available).
  • A ureteric stent is left with an Indwelling Urethral catheter.
  • A ureteric stent is placed for 6 weeks and an indwelling catheter overnight.

What next?

  • You may be in hospital for 1-2 days.
  • You may have continuous intravenous antibiotics on board.
  • You may have persistent hematuria.
  • The stent may be uncomfortable with pain radiating to your affected kidney every time you urinate.
  • Your stent will be removed on a separate occasion in 6 weeks with a flexible cystoscopy under Local Anesthesia.
  • A follow-up appointment will be scheduled for 6 weeks to review your symptoms.
  • A further follow-up may be arranged with a CT IVP to check on the end result of the ureter.
  • DON’T SUFFER IN SILENCE, OR YOU WILL SUFFER ALONE!

 

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Wes Ureterotomy

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