The ureters are the tubes that transport urine from the kidneys to the bladder, which after the formation of scars creates stricture or narrowing pattern in the tube. These scar tissues are formed because of an accident or after a surgery else it may also be due to cancer or endometriosis. This narrowing may lead to reduced flow of the urine, sometimes no flow of the urine is also experienced. This urine then backs up into the renal system that is inside the kidneys, which causes pain and can further lead to urinary tract infection or kidney damage or kidney infection. Ureteroplasty is the surgical removal of the stricture.
Procedure:
The surgery will be done via making several small incisions this is what laparoscopy is meant for. Else the surgery will be done via one large incision that is known as open surgery. Open surgery sometimes is done for some of the safety reasons.
If laparoscopy is decided, then the doctor makes various small incisions in the abdomen region. The scope is inserted in one of the small incisions, this scope sends pictures from inside the abdomen to the video screen installed in the operation theatre. Surgical tools are placed via other incisions made. In such cases laparoscopy can done, the laparoscopy system gives away a 3D view inside the body and thus in turn assists in the hand movements of a surgeon.
During the surgery:
● The portion of the ureter that is narrowed is cut out.
● If the larger portion is cut out, then tissue will be used to repair the ureter.
● Tissue to repair the ureter will be taken from another part of the body such as bladder.
● The cut ends of the ureter tubes will be stitched together with great precision.
● These stitches will get dissolved with time.
● A flexible tube known as stent is put into the ureter, it will reach from kidneys to the bladder.
● This is kept for four to six weeks after the surgery to help in the position of the ureter, when it is in the healing process.
● When the surgery is all over, incisions are closed with sutures, staples and surgical glue. Drains are put near the incisions to drain fluid buildup after the surgery.
Recovering in the hospital:
While in the hospital–
● Patient will be given medicine for the pain management.
● Catheter in the urethra will be removed.
● Any such drains will likely be removed before the patient go home.
Recovering at home:
Make sure to–
● Take all medicine as directed
● Avoid bathing, swimming, using a hot tub that cause the incision to be covered with water.
● Follow your doctor’s guidelines for showering.
● Avoid heavy lifting and strenuous activity as directed.
● Avoid straining during a bowel movement.
● Do not drive until you are no longer taking prescription pain medicine.
● If needed, take stool softeners as directed by your doctor.
Complications:
• Urge to pass urine more often due to stent.
• Burning sensation in urine.
• Blood in urine will be observed.