Ileal ureter or ureteral repair using a bowel segment (intestine) is a procedure in which the ureter is mostly or completely replaced with a part of the small bowel. This is necessary for long (over 8 cm) or multiple scar-related narrowings of the ureter that obstruct urine flow.

In about three-quarters of the cases, this narrowing is a result of medical procedures or previous radiation.

Patients often suffer from flank pain due to urinary retention and problems during urination. Other possible consequences include recurring urinary tract infections, stone formation, chronic kidney failure, and in the worst case, loss of kidney function.

Ureteral reconstruction with a segment of the small bowel is a rare, large, and complex urological operation that requires a functional kidney, harvesting of a part of the small bowel, and special preparation. Limitations exist for patients with intestinal diseases or previous intestinal surgeries.

The Da-Vinci ileal ureter is a robot-assisted, minimally invasive keyhole surgery requiring special surgical expertise. Instruments are introduced under general anesthesia through small abdominal incisions and then controlled by the surgeon via a console.

During the operation, an appropriate part of the small bowel is first isolated while preserving its blood supply (blood vessels), and its continuity is restored. Then, the ureter is replaced with this part of the bowel, and the other end of the bowel is implanted in the bladder. Subsequently, an internal ureteral and bladder catheter is inserted for healing.

The success of the operation depends on the team’s experience and specific patient data.

Every surgery carries certain risks, such as bleeding during or after the operation, damage to adjacent organs, or wound healing problems.

Previous surgeries, illnesses, or medications can affect the course of the operation and postoperative recovery. These risks are assessed individually based on the patient’s medical history.

Possible side effects include urinary retention, recurrence of scarring obstructing urine flow, urine leakage, inflammations, and urinary tract infections. Intestinal complications such as obstruction, leaks, and delayed activity, which may require further interventions, are also possible.

The operation aims at restoring normal urine flow; therefore, continuous monitoring of the kidneys is essential. A balanced diet, adequate fluid intake, exercise, and sleep support recovery and strengthen long-term health.