Plastics of the ureteric segment

A loyalty program is available for surgical interventions in the hospital, which makes treatment even more affordable.

Uretropelvic segment plasty - this is an operation performed to restore normal urine flow from the kidney through the ureter to the bladder. It is prescribed for obstruction of this segment and the development of hydronephrosis.

Renal hydronephrosis - this is a pathological condition that manifests itself in the expansion of the renal calyces and pelvis. Without timely treatment, it causes atrophy of the renal parenchyma and thinning of the organ tissues. As the disease progresses, the changes become irreversible and renal failure develops.

One of the most effective treatment options is uretropelvic segment plasty. During the operation, the surgeon excises the affected tissues and forms an anastomosis - connects the renal pelvis with healthy ureter tissues; or uses the method of longitudinal dissection of the segment with subsequent suturing in the horizontal plane.

Until recently, such an operation was performed through open access, which is associated with the risk of complications and a difficult rehabilitation period. Currently, leading clinics use the laparoscopy method - instead of incisions, several small punctures are made, through which a laparoscope with a video camera and trocars with miniature surgical instruments are inserted.

Laparoscopic ureteroplasty:

• is a minimally invasive operation - instead of an incision, 3-4 punctures with a diameter of about 1 cm are made;

• allows you to avoid significant blood loss and reduce the risk of infectious complications;

• does not require prolonged hospitalization - the patient is discharged for 2-3 days;

• accompanied by an easier and shorter rehabilitation period.

At «Oxford Medical» the operation is performed by urological surgeons with over 20 years of experience. The presence of high-tech equipment allows them to perform laparoscopic ureteral segment plastic surgery even in the most complex cases.

The operation is prescribed when the normal outflow of urine is disturbed due to narrowing of the lumen of the ureter or compression of the ureteral segment (with hydronephrosis of 2 degrees and more).

The cause of hydronephrosis can be:

• congenital narrowing of the ureteral segment (is the main cause of hydronephrosis of the kidney in children);

• ureteral strictures;

• adhesions;

• urolithiasis;

• neoplastic tumors of the abdominal cavity and retroperitoneal space;

• traumatic injuries ureter.

Before surgery for hydronephrosis of the left or right kidney, the patient is prescribed a comprehensive examination.

It may include:

• Ultrasound of the urinary system;

• Excretory urography;

• Computed tomography (if indicated).

• Blood and urine tests.

It is recommended to stop taking medications that affect blood clotting 2 weeks ago, as they can provoke the development of severe bleeding.

After 2-3 days, you should switch to a light diet, on the day of surgery - do not eat or drink anything. It may also be necessary to cleanse the intestines with an enema.

Patients with chronic diseases are recommended to consult with specialized doctors and an anesthesiologist in advance.

At «Oxford Medical» ureteroplasty is performed laparoscopically. For this purpose, high-tech equipment is used, which allows you to do without a wide incision and perform all manipulations with maximum accuracy.

Before the operation, the patient is put into a state of anesthesia. After that, carbon dioxide is injected into the abdominal cavity through a needle puncture. It provides lifting of the abdominal wall and formation of free space for performing surgical manipulations.

Next, the surgeon makes 4-5 trocar punctures on the abdominal wall. Through one of them, he inserts a laparoscope equipped with a wide-resolution video camera with a built-in LED. The image from it is transmitted to the monitor screen and magnified many times. Through other punctures, the surgeon inserts trocars with miniature surgical instruments.

Then the surgeon isolates the kidney with the upper third of the ureter.

Next, the plastic surgery is performed using one of the following methods:

• Anderson-Hines method (resection) – involves resection of the affected tissues of the ureter and pelvis at the site of the dilation with subsequent anastomosis, i.e. the connection of healthy tissues of the pelvis and ureter;

• Fenger method – involves dissection of the ureteral segment along with subsequent connection in the horizontal plane, which provides expansion of the area of ​​connection of the renal pelvis and ureter.

Today, the first method is most often used. After the formation of a new wide confluence between the pelvis and the ureter, the surgeon installs a stent in the ureter, which ensures drainage and proper healing of the anastomosis. After 2-3 weeks, the stent is removed endoscopically (through the urethra).

After the operation, the patient is transferred to the intensive care unit. There, he gradually comes out of anesthesia under the supervision of specialists. If he feels well, he will soon be transferred to a hospital ward.

«Oxford Medical» is equipped with comfortable hotel-type wards with a private bathroom. They are designed for one or two patients. If desired, it is possible to order three meals a day.

On the day of the operation, the patient is recommended to adhere to bed rest. Getting up and restoring nutrition are carried out the next day. The patient is discharged for 3-4 days.

To eliminate pain syndrome, prevent complications and successfully heal tissues, the patient is prescribed painkillers, anti-inflammatory, antibacterial and other drugs according to indications.

After 2-3 weeks, an ultrasound scan and removal of the ureteral stent are performed.

Laparoscopic surgeries have a significantly lower risk of complications than open surgeries. Due to the introduction of trocars through punctures with a diameter of up to 1 cm, damage to healthy tissues is reduced and blood loss and the likelihood of infection are reduced. Complications such as damage to adjacent organs during surgery are also minimized due to the high professionalism of the surgeons of «Oxford Medical» and the use of expert-class equipment with a powerful optical system.

Potential complications of ureteropelvic segment plasty include bleeding, infection, damage to adjacent organs, and the formation of a postoperative hernia, but they occur in no more than a few percent of patients.

At «Oxford Medical» urological surgeries are performed in a modern surgical department with two operating rooms equipped with expert-class equipment. It allows for laparoscopic urethroplasty, which reduces the risk of complications, shortens the length of hospitalization, and facilitates postoperative recovery.

The clinic's surgeons have over 20 years of experience and have performed hundreds of successful surgeries. They regularly undergo training in new methods so that our patients receive high-quality medical care that meets the highest world standards. 

The cost of the surgery may vary depending on the complexity. You can find out about the prices here. A urologist will advise you more specifically on this issue during a preliminary consultation. Make an appointment at a time convenient for you.