Ureteric Reimplantation

Your child has been diagnosed with vesico-ureteric reflux (“reflux”). This is a condition that allows urine to reflux (flow back up) the ureter to the kidney when the pressure in the bladder is increased. This is graded 1 – 5, with one being very minor and 5 being very severe. Grading is done on the basis of the findings at the cystogram, the x-ray procedure where dye is put into the bladder and observed entering the ureters and kidney. Children with reflux are susceptible to urine infections, which can lead to kidney scarring and damage or in more severe cases, the ureter and kidney becomes large, distorted and inefficient.

A ureteric reimplantation is an operation to treat reflux.

The operation is done to correct the faulty “flap-valve” where the ureter enters the bladder and thus prevent
reflux from occurring.

The child is anaesthetised and a small bikini line incision is made. Through this the bladder can be approached and opened. The opening of the ureter is found and a small circular incision is made around it. The ureter is dissected free from the bladder muscle. When the ureter can slide in and out of the bladder wall freely, a small tunnel is made for each ureter, approximately 2cm long, with the end opening into the bladder. The ureter is then passed through this tunnel and stitched into place. This is so that in the future, when the bladder muscle contracts to pass urine, the sides of the ureter will be pressed together and stop urine flowing back up to the kidney. The site of the original opening of the ureter is then closed and the bladder is also closed.