Reconstruction of the Ureter
This article is written by our team of reconstructive urological surgeonsfor patients with narrowing or complete loss of the ureter. Perhaps only patients with ureteral damage and doctors dealing with this complex branch of medicine are able to fully appreciate the expression "ureteral invalid."
In our bodies, there are many seemingly inconspicuous organs, the failure of which can cause a sudden deterioration in the quality of life or even a threat to life itself. Just think of the appendix, a tiny appendage of the intestine, inflammation of which, without immediate surgical intervention, can almost inevitably lead to death.
While appendicitis can quickly be fatal, damage to or removal of the ureter turns a person into a so-called "ureteral invalid." Since narrowing or compression of the ureter leads to the inability of urine to flow from the kidney, patients are forced to constantly wear a nephrostomy tube. The nephrostomy tube is a catheter that drains urine from the kidney into a special bag, which also has to be carried at all times. In such cases, one can simply forget about a normal social life or any kind of activity.
Nephrostomy(also known as nephrostomic catheter or drainage, CPNS, renal catheter) is a hollow tube that is inserted at one end into the renal pelvis for collecting and draining urine, while the other end is attached to a urine collection bag. The nephrostomy tube passes through the skin, so it may also be referred to as a percutaneous drainage. In addition to the natural household and hygienic inconveniences, a nephrostomy requires regular replacement and maintenance.
The exit site of the tube from the skin needs to be regularly treated with antiseptics, and so on. Besides the obvious drawbacks, wearing this drainage entails two major dangers
Issues with having a nephrostomy
Prolonged wearing of a nephrostomy is a necessary measure that leads to kidney inflammations, radical deterioration in the quality of life, and unfortunately, the death of the patient withina few years due to chronic renal insufficiency.
Before we delve into describing various methods of reconstructive-plastic surgery of the ureter, it is worth noting that such operations are carried out only in specialized centers. Reconstructive surgeries in general, and ureter reconstruction in particular, are considered the "pinnacle" of urological surgery. Simply because restoring is always more challenging than, for example, removing a kidney. Such operations require not only the personal skill of the surgeon but also the cohesive teamwork of specialists, state-of-the-art equipment, and a responsible approach to choosing the methodology.
In our clinic, all types of ureter reconstructions are performed, from standard Boari flap procedures to simultaneous reconstruction of both ureters and the urinary bladder.
What types of ureter surgeries are performed?
How is treatment carried out in our clinic
During the initial consultation, we evaluate the results of previous examinations and surgeries, perform preliminary analyses, and assess the patient's overall condition. The most suitable method for ureter reconstruction is chosen during the consilium.
Preparation for surgery is strictly individualized for each patient: it is necessary to assess too many factors to standardize this examination. Bowel preparation is conducted using modern methods as part of the preoperative process.
Day of the operation. In the morning of this day, we recommend not eating or drinking. On the night before the surgery, we provide the patient with a sedative to alleviate anxiety and allow for a good night's sleep. Additionally, preliminary antibiotic therapy is administered before the surgery. |
Inpatient observation and treatment involve careful monitoring of the patient's health, allowing us to adjust the treatment accordingly. The most important aspect at this stage is early patient mobilization, which facilitates rapid recovery.
It is important to understand that reconstructive surgeries require careful patient monitoring. During the first year after the operation, we invite the patient for follow-up appointments every three months, and afterward, every six months. This allows for prompt and effective treatment in case of recurrence. |
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