Ureteral Surgery – Pediatric

Duplicated ureter.svg

Ureteral surgeries are procedures employed to correct urine flow and problems with the kidneys and ureters. These surgeries may be necessary if there is a blockage within the ureter or an individual experiences vesicoureteral reflux.

What is it?

The ureters transport urine from the kidneys to the bladder. If children are suffering from ureteral blockage or vesicoureteral reflux, kidney and ureter damage may occur. Vesicoureteral reflux occurs when the urine refluxes or backs up from the bladder to the kidney. Usually, children outgrow this, and the condition can be managed without surgery. If there are no other alternatives, ureteral surgery may be necessary to remove blockages or prevent further reflux.

What should I do to prepare?

Patients will meet with an anesthesiologist before the surgery as this procedure will require the patient completely sedated. A cystoscopy, insertion of a camera through the urethra, may be performed to plan the surgery, but it is not routine. Additionally, the patient should refrain from taking blood thinners during the week prior to surgery since these drugs increase the risk of bleeding during operation. Patients cannot eat or drink during the evening before the surgery to avoid complications with anesthesia such as aspiration. When a patient is put under anesthesia, it is possible for food in the stomach to be expelled to the lungs.

What happens during the process?

General anesthesia is used to completely sedate the patient so that they will not feel the procedure or be able to wake during it. A ureterectomy may need to be done in extreme cases, consisting of removal of an entire ureter or part of a ureter, then reconstruction using other tissues. In less severe cases, ureteral obstructions can be identified using a percutaneous nephrostomy, a catheter, or an insertion of a ureteral stent, which widens the ureter, fixing the issue of obstruction. These surgeries can be completed laparoscopically or in an open manner, which means the surgeon will only make small incisions and use a small camera to aid in seeing within the body during the surgery.

What are the risks and potential complications?

Complications of ureteral surgeries include, but are not limited to:

  • Prolonged urinary leakage
  • Sepsis
  • Infection
  • Lengthened hospital stays
  • Infection
  • Pain
  • Loss of renal function


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Image Source: https://commons.wikimedia.org/wiki/Category:Ureter#/media/File:Duplicated_ureter.svg