Ureteric Injury

Infrequently ureteric injuries can occur with other abdominal surgery i.e.:

If the injury is below the pelvic brim, then a re-implantation with is recommended with Boari-flap, otherwise a primary end-to-end anastomosis

Stricturing or narrowing of the ureter causing significant hydronephrosis.
Injury to ureter with Urological surgery can cause this: Ureteroscopy.
Injury to the ureter from other surgeries: Colorectal, Gynecological.
This injury if not noted may lead to chronic infection, peritonitis, sepsis etc.
End-result is loss of renal function and an ICU stay.
An end-to-end anastomosis can be considered in the mid ureter.
A Reimplantation into the bladder with lower ureteric strictures.
A pelvi-ureteric junction repair in higher ureteric strictures.
A trans uretero-ureteric anastomosis joining one ureter to the other where long defects are present.
Renal Auto Transplantation where ureter is completely damaged or an ileal ureteric substitution where the whole ureter is damaged.

Patients will receive a general anesthesia.
Prophylactic antibiotics is given.
The correct ureteric system is identified and marked while you are awake.
Robotic ports are placed,
The affected ureter is exposed, the defect cut out with a re-anastomosis of a spatulated proximal ureter to the distal ureter over a ureteric stent.
An indwelling catheter is placed.
A drain is placed.

You may be in hospital for a few days
A drain will be left overnight and removed the next day if not draining any fluid.
Your catheter will be removed the following day. Or as soon as your urine is clear.
As soon as you are comfortable with no signs of pain and emptying your bladder sufficiently, you will be discharged.
A ward prescription may be issued on your discharge, for your own collection at any pharmacy.
A follow-up appointment will be scheduled for 6 weeks to remove your ureteric stent under local anesthesia with a Flexible Cystoscope.
A review with a CT IVP will be scheduled 6 weeks after this to check on the end result of the ureter.
DON’T SUFFER IN SILENCE, OR YOU WILL SUFFER ALONE!