Users' questions

What is ileal ureter replacement?

What is ileal ureter replacement?

Ileal ureter replacement is a technically feasible surgery to be performed in any patient requiring ureteral reconstruction despite a normal contralateral kidney. As such, it is a better alternative than nephrectomy in cases of complex and multiple ureteral strictures.

What is an ileal ureter?

Morgan ◉ et al. Ileal ureter interpositions are uncommon urologic reconstructions, using a loop of small bowel to replace a damaged ureter. The concept is similar to the formation of a neobladder from small bowel (e.g. ileal conduit), except one is forming a neo-ureter.

Can a damaged ureter be replaced?

When the mid-portion of the ureter is surgically injured, the ureter can be repaired by sewing the two cut ends together as long as the gap between them is less than 3 cm. At the time the ureter is sewn together a stent (plastic tube) is also placed in the ureter. The stent helps the ureter to heal.

How are ureters resected to create an ileal conduit?

To create an ileal conduit, the ureters are surgically resected from the bladder and a ureteroenteric anastomosis is made in order to drain the urine into a detached section of ileum at the distal small intestine, though the distal most 25 cm of terminal ileum are avoided as this is where bile salts are reabsorbed.

How long does it take to hold urine after bladder surgery?

After your surgery, your urine will flow from your kidneys, through your ureters and ileal conduit, and out of your stoma. You will wear a urostomy pouching system (appliance) over your stoma to catch and hold the urine. This surgery usually takes about 3 to 6 hours.

Can a doctor remove lymph nodes from the bladder?

If you’ve had surgery or radiation therapy to your pelvis in the past, your doctor may remove fewer lymph nodes. This is done to avoid problems after your surgery. In addition to your bladder and lymph nodes, your doctor may need to remove other organs near your bladder. This is done to make sure all of the cancer is removed.

How is an ileal conduit created after a bladder removal?

Creating Your Ileal Conduit. After your bladder is removed, your doctor will create a new passage where urine will leave your body. This is called a urostomy. The type of urostomy you will have is called an ileal conduit. Your doctor will use a small piece of your intestine called the ileum to create the ileal conduit.

How long does urinary incontinence last after surgery?

While regaining control of urination, urinary incontinence (leakage of urine) is normal after surgery, but might last up to six months. Also, about 20% of patients during the night and 5% to 10% of patients during the day are incontinent (leak urine) and have to wear a pad.

Can a large uterus cause an ureter injury?

It is most commonly injured during gynecological surgery. Colorectal surgery also can lead to ureter injury. In patients who have a large uterus due to benign fibroids or cancer, a large sized rectal or sigmoid colon cancer, or have received prior pelvic radiation, the normal ureter anatomy may be very distorted.

What are the side effects of ureter reconstruction?

By freeing up and stretching the bladder and rolling a segment of it into a tube, the bladder sometimes becomes a little unstable, causing frequent urination. It will often take months for the bladder to stretch up till normal. If the urinary side effects are annoying, there is good medicine to calm the bladder down (Ditropan).