Our Summary

The paper reports on a study that looked at the use of laparoscopic surgery (a less invasive type of surgery) to fix issues with the ureter (the tube that carries urine from the kidney to the bladder) in children, specifically after an initial open surgery had failed. The researchers used a technique known as a ‘psoas hitch’, which helps to create a longer tunnel and relieves tension, making the new connection more efficient.

The study looked at 17 patients who had this laparoscopic surgery after a failed open surgery. The researchers found that the diameter of the ureter was significantly reduced after the surgery, and tests showed that the kidneys were functioning well and there were no obstructions.

The conclusion of the study is that this laparoscopic approach, with the use of a psoas hitch, is a safe and effective way to fix issues with the ureter after an open surgery has failed.

FAQs

  1. What is the ‘psoas hitch’ technique used in ureteral reimplantation?
  2. What were the results of the study on the use of laparoscopic surgery for ureteral reimplantation after a failed open surgery?
  3. Is laparoscopic surgery with the use of a psoas hitch considered a safe and effective way to fix issues with the ureter?

Doctor’s Tip

A doctor might advise a patient undergoing ureteral reimplantation to follow post-operative care instructions carefully, including taking prescribed medications, maintaining proper hygiene, and attending follow-up appointments to monitor progress and address any concerns. It is important to follow a healthy lifestyle, including staying hydrated and avoiding activities that could put strain on the surgical site. It is also important to report any unusual symptoms or signs of infection to your healthcare provider immediately.

Suitable For

Patients who may be recommended for ureteral reimplantation include those with:

  1. Recurrent urinary tract infections
  2. Vesicoureteral reflux (a condition where urine flows backward from the bladder to the kidneys)
  3. Ureteral strictures (narrowing of the ureter)
  4. Ureteropelvic junction obstruction (blockage where the ureter meets the kidney)
  5. Ureteral stenosis (abnormal narrowing of the ureter)
  6. Ureteral trauma or injury
  7. Congenital anomalies affecting the ureter
  8. Complications from previous ureteral surgeries

Overall, patients with persistent ureteral issues that cannot be managed with conservative treatments may be recommended for ureteral reimplantation surgery.

Timeline

Before the surgery:

  1. Patient experiences symptoms such as urinary tract infections, kidney stones, or urinary incontinence due to issues with the ureter.
  2. Patient undergoes initial open surgery to try to fix the issue, but it is unsuccessful.
  3. Patient continues to experience symptoms and complications related to the ureter problem.

After the surgery:

  1. Patient undergoes laparoscopic surgery with a psoas hitch technique to fix the ureter issue.
  2. The diameter of the ureter is significantly reduced, indicating successful surgery.
  3. Kidney function tests show that the kidneys are functioning well and there are no obstructions.
  4. Patient experiences relief from symptoms and complications related to the ureter issue.
  5. Patient undergoes follow-up appointments to monitor recovery and ensure the success of the surgery.

What to Ask Your Doctor

  1. What is ureteral reimplantation and why is it necessary?
  2. What are the risks and benefits of laparoscopic surgery compared to open surgery for ureteral reimplantation?
  3. How long is the recovery time after laparoscopic ureteral reimplantation?
  4. What are the success rates of laparoscopic ureteral reimplantation compared to open surgery?
  5. Are there any specific lifestyle changes or precautions I should take after the surgery?
  6. How often will I need follow-up appointments and tests to monitor the success of the surgery?
  7. Are there any potential complications or side effects I should be aware of?
  8. Will I need any additional treatments or procedures after the ureteral reimplantation surgery?
  9. How experienced is the surgical team in performing laparoscopic ureteral reimplantation procedures?
  10. Are there any alternative treatment options for my condition that I should consider?

Reference

Authors: Shumaker AD, Kord E, Dubrov V, Bondarenko S, Visman Y, Stav K, Zisman A, Neheman A. Journal: Eur J Pediatr Surg. 2023 Feb;33(1):41-46. doi: 10.1055/a-1905-4636. Epub 2022 Jul 20. PMID: 35858643