Product Summary: AMA rates
Repair of ureteric injury
Item Number: 36573, 105
Infrequently ureteric injuries can occur with other abdominal surgery i.e.:
- Hysterectomy.
- Ovarian mass resection.
- Bowel resections.
- Sacro Colpo-pexy.
If the injury is below the pelvic brim then a re-implation with is recommended with Boari flap, otherwise a primary end-to-end anastomosis
Why is it done?
- 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, Gynaecological.
- This injury if not noted may lead to chronic infection.
- End-result is loss of renal function.
- An end to end anastomosis can be considered in the mid ureter.
- A Reimplantaion 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.
How is it done?
- Laparoscopic technique.
- Patients will receive a general anaesthesia.
- Prophylactic antibiotics is given.
- The correct ureteric system is identified and marked while you are awake.
- This will be mostly a laparoscopic procedure.
- Laparoscopic ports are placed, 1 for camera and 1-2 as working ports.
- The affected ureter is exposed, The defect cut out with a re-anastomosis of a spatulated proximal ureter to a the distal ureter over a ureteric stent.
- An indwelling catheter is placed.
- A drain is placed.
What next?
- You may be in hospital overnight.
- 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 anaesthesia 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.
- Any pain or signs of fever require an urgent review.
- Don’t hesitate to ask Jo if you have any queries.
- DON’T SUFFER IN SILENCE, OR YOU WILL SUFFER ALONE!
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