Our Summary

This study compared two types of surgery for ureteral disease: robot-assisted ureteral reimplantation (RAUR) and open ureteral reimplantation (OUR). The researchers looked at patients who had these surgeries between 2016 and 2020. They found that the two groups of patients were similar before and after surgery. However, the robot-assisted surgery had some advantages. It took less time (216 minutes compared to 317 minutes) and resulted in less blood loss (35 mL compared to 175 mL). There was no difference in the rate of complications between the two types of surgery. Patients who had the robot-assisted surgery also spent less time in the hospital (2 days compared to 6 days) and had a shorter catheterization time (16 days compared to 28 days). The researchers concluded that robot-assisted surgery is a safe and effective alternative to open surgery for treating ureteral disease. It has similar success rates but results in less surgical complications and faster recovery times.

FAQs

  1. What are the main differences between robot-assisted ureteral reimplantation (RAUR) and open ureteral reimplantation (OUR)?
  2. Does the robot-assisted ureteral reimplantation surgery result in fewer complications compared to the open surgery?
  3. Is the recovery time shorter for patients who undergo robot-assisted surgery compared to those who undergo open surgery for ureteral disease?

Doctor’s Tip

One helpful tip a doctor might tell a patient about ureteral reimplantation is to follow the post-operative care instructions closely. This may include taking prescribed medications, avoiding strenuous activities, and keeping the surgical site clean and dry. It is important to attend all follow-up appointments and communicate any concerns or changes in symptoms to your healthcare provider. By following these instructions, you can help ensure a successful recovery and minimize the risk of complications.

Suitable For

Patients who are typically recommended ureteral reimplantation include those with:

  1. Recurrent urinary tract infections (UTIs) associated with vesicoureteral reflux (VUR)
  2. Ureteral strictures or narrowing
  3. Ureteral obstruction or blockage
  4. Ureteral injury or trauma
  5. Congenital abnormalities affecting the ureters

These patients may experience symptoms such as frequent UTIs, flank pain, hematuria (blood in the urine), or urinary incontinence. Ureteral reimplantation may be recommended when conservative treatments such as antibiotics or ureteral stenting are not effective in resolving the underlying issue.

Timeline

Before ureteral reimplantation:

  • Patient presents with symptoms such as frequent urinary tract infections, urinary incontinence, and kidney stones
  • Diagnostic tests such as renal ultrasound, CT scan, and cystoscopy are performed to determine the cause of the symptoms
  • Urologist recommends ureteral reimplantation as a treatment option

During ureteral reimplantation:

  • Patient undergoes pre-operative preparation including fasting and anesthesia administration
  • Surgery is performed, either open ureteral reimplantation or robot-assisted ureteral reimplantation
  • Ureter is repositioned and reattached to the bladder to correct the urinary tract issue
  • Patient is monitored in the recovery room before being transferred to a hospital room

After ureteral reimplantation:

  • Patient experiences post-operative pain and discomfort which is managed with pain medications
  • Patient is monitored for any complications such as infection or bleeding
  • Patient may have a catheter in place to drain urine from the bladder
  • Patient is discharged from the hospital once stable and given post-operative care instructions
  • Follow-up appointments are scheduled to monitor recovery and address any issues that may arise

What to Ask Your Doctor

  1. What are the potential risks and complications associated with ureteral reimplantation surgery?
  2. How long is the recovery period after ureteral reimplantation surgery?
  3. Will I need to have a catheter after the surgery, and if so, for how long?
  4. How long will I need to stay in the hospital after the surgery?
  5. What is the success rate of robot-assisted ureteral reimplantation compared to open surgery?
  6. How experienced are you in performing robot-assisted ureteral reimplantation surgery?
  7. What can I expect in terms of pain management after the surgery?
  8. Are there any specific post-operative instructions or restrictions I need to follow?
  9. Will I need any additional follow-up appointments or tests after the surgery?
  10. Are there any alternative treatment options for my ureteral disease that I should consider?

Reference

Authors: Carbonara U, Branche B, Cisu T, Crocerossa F, Guruli G, Grob MB, Roseman JT, Hampton LJ, Autorino R. Journal: J Endourol. 2021 Oct;35(10):1504-1511. doi: 10.1089/end.2021.0083. PMID: 34098751