Ureteric reimplantation is a surgical procedure to repair the connection between the ureter (the tube draining the kidney) and the bladder. The robotic approach provides precision and a quicker recovery while maintaining excellent long-term outcomes.
TREATMENTS
Robotic Ureteric Reimplantation
When Is Ureteric Reimplantation Recommended?
The ureter-bladder junction may need to be surgically reconstructed in several circumstances:
• Ureteric leak or stricture — narrowing of the ureter caused by previous surgery, radiation, or injury
• Ureteric obstruction caused by endometriosis or other external compression
• Cancer in the lower or middle ureter that is not suitable for endoscopic treatment
Reconstruction Techniques
• Robotic ureteric reimplantation: The ureter is detached from the bladder and the healthy section is implanted into the bladder.
• Psoas hitch or Boari flap: Techniques that mobilise the bladder, anchoring it to the psoas muscle or combined with Boari (a bladder flap), to bridge longer gaps without tension on the ureter
• Advanced techniques: Options such as buccal mucosal grafting, bowel interposition, nephropexy (repositioning the kidney lower) or auto-transplantation for ureteric problems closer to the kidney.
• Endoscopic options: For selected short strictures, or patients not suitable for reconstruction, an endoscopic approach may be attempted with laser, balloon dilatation or long-term stenting.
Risks and Considerations
All procedures carry risks, which your surgeon will discuss with you in detail. These may include:
• Urine leak while the join heals
• Recurrent narrowing over time — long-term imaging follow-up is arranged
• Urinary reflux (urine washing back towards the kidney), which is usually harmless in adults
• Stent-related bladder symptoms until removal
Recovery at a glance: Usually 1–3 nights in hospital with robotic surgery; catheter for about two weeks and stent removal around 6 weeks.
1
Pre-Operative Planning
CT urography, nuclear medicine scans (MAG3/DTPA), and cystoscopy with contrast studies assess the position and length of the problem, bladder capacity, and guide the reconstructive options.
2
Robotic Reconstruction
Using small abdominal incisions, the ureter is carefully mobilised and re-implanted into the bladder using precise suturing techniques.
3
Stenting and Healing
A ureteric stent placed at surgery supports the new join and is removed with a short cystoscopy at 4–6 weeks. A catheter is also left for around two weeks.
4
Outcome Monitoring
Imaging at three months confirms relief of the obstruction and recovery of kidney function. Ongoing blood tests and imaging continue the monitoring.
Our Approach
