Ureteral reimplantation is the translocation of the ureter orifice to a new position in the bladder. It is performed due to a scar-related narrowing (stricture) of the lower ureter that obstructs urine flow.

In about three-quarters of the cases, this narrowing results from medical procedures or previous radiation.

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

For reconstruction, the affected kidney should be functional.

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

During the procedure, the ureter is cut above the stricture and transplanted to a new position in the bladder. The bladder is brought up to the ureter and attached to the underlying muscle (Psoas Hitch technique). In some cases, a part of the bladder is used to bridge the distance of the ureteral defect (Boari technique). Subsequently, an internal ureteral and bladder catheter are 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, inflammations, urine leakage, and urinary tract infections.

After the surgery, which aims at restoring normal urine flow, continuous monitoring of the kidneys is essential. Moreover, a balanced diet, adequate fluid intake, exercise, and sleep support recovery and strengthen long-term health.