Ureteric Re-implantation in Sharjah
Medically reviewed by Dar Al Kamal Team
What is ureteric re-implantation?
Ureteric re-implantation is a reconstructive operation on the lower end of the ureter, the tube carrying urine from a kidney to the bladder. Normally, each ureter enters the bladder at a slant and runs for a short distance under the bladder lining. As the bladder fills, it presses that stretch of ureter flat, which stops urine flowing backwards. This natural flap valve is what the operation recreates or restores.
In re-implantation the surgeon frees the ureter where it joins the bladder and attaches it again, either through a longer tunnel under the lining, to correct backflow, or to a healthy part of the bladder, to bypass a damaged segment.
At Dar Al Kamal Hospital, Sharjah, the consultant urologist performs ureteric re-implantation in-house, through a small incision low in the abdomen or, for suitable cases, by keyhole surgery as described on the laparoscopic urology page.
Who needs it
In children, the usual reason is vesicoureteral reflux, where urine flows back up from the bladder towards the kidney because the tunnel is too short. Reflux is graded from mild to severe on a special X-ray. Many children, especially with milder grades, outgrow reflux as the tunnel lengthens with growth, and care starts with the pediatric urology team, prompt treatment of infections and, often, a low-dose preventive antibiotic.
Re-implantation is considered for a child with:
- repeated kidney infections with fever despite preventive treatment
- new scarring of the kidney on a scan
- higher grades of reflux that persist as the child grows
- reflux combined with a blockage or other difference where the ureter enters the bladder
A small injection of bulking material at the ureter opening, given through a telescope, is an alternative for some children, and the urologist explains how it compares.
In adults, re-implantation repairs the lower ureter after injury during pelvic or abdominal surgery, a narrowing from scar tissue after a stone or earlier treatment, or a narrowing close to the bladder for another reason. If the ureter is too short to reach the bladder comfortably, the bladder can be stitched up towards it, a step called a psoas hitch. Treatment for urinary infections and imaging usually come first.
What happens
Ureteric re-implantation is done under general anaesthesia. In children, a local anaesthetic block is often added for comfort afterwards.
For reflux, the surgeon opens the bladder, frees the end of the ureter, and creates a longer tunnel under the bladder lining so the ureter lies flat against the bladder muscle as the bladder fills. For an adult repair, the damaged segment is removed and the healthy ureter joined to the bladder in a fresh spot, sometimes with the bladder raised to meet it.
A soft stent is often left inside the ureter to protect the new join, and a urinary catheter drains the bladder for the first days. Bladder spasms, a cramping feeling low in the tummy, are common after bladder surgery and are treated with medicine. Most people stay in hospital for a short period; children stay with a parent.
Preparing for it
A urine test checks for infection, which is treated first. Blood tests and an anaesthetic review follow. Bring previous scan reports, including the reflux X-ray and any kidney scarring scan, because they guide the operation and future comparisons.
For children, keep up any preventive antibiotic unless told otherwise, explain the hospital stay simply and bring a comfort toy. Adults should list all medicines and arrange help at home. Raise Ramadan timing early.
Afterwards
The catheter and any stent come out as planned by the team; a stent is often removed with a short telescope check. Blood-tinged urine and bladder spasms settle over the early period. Keep the wound clean and dry, which needs extra care in the Sharjah heat, and drink steadily.
Follow-up includes urine checks whenever a fever appears and a scan to confirm the kidney drains well. For children, the team advises when the preventive antibiotic can stop. Adults get a personal plan for desk work, driving and manual work.
Contact the hospital urgently if you or your child has a fever, the wound reddens or leaks, or bladder spasms keep getting worse. **Go to the emergency department straight away for a high fever with side pain or vomiting, or an inability to pass urine.**
Cost and insurance
Most UAE insurance plans cover ureteric re-implantation when it is medically needed, and it requires pre-approval supported by imaging and a record of infections or injury. Stent removal and follow-up scans may be approved separately. Dar Al Kamal Hospital, Sharjah can help you confirm cover and start approval early on 06 599 7777.
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Frequently asked questions
What are the risks of ureteric re-implantation?
Ureteric re-implantation carries the risks of any bladder operation, including bleeding, infection, bladder spasms and a reaction to the anaesthetic. Specific risks are a narrowing at the new join that blocks drainage, and reflux that persists. Your urologist explains how these apply to you or your child.
Will my child grow out of reflux?
Many children grow out of reflux, especially milder grades, because the tunnel lengthens as the bladder grows. Regular follow-up shows whether it is settling or whether surgery is worth discussing.
Does re-implantation stop urinary infections?
Re-implantation stops urine flowing back to the kidney, which protects the kidney from infection travelling upwards. Bladder infections can still happen, so good toilet habits and treating constipation remain important.
Is there an alternative to open surgery for reflux?
An injection of bulking material at the ureter opening, given through a telescope, is an alternative for some children with reflux. It avoids an incision, and the urologist explains how it compares for your child's grade.
What is a psoas hitch?
A psoas hitch is a step in adult re-implantation where the bladder is stitched to a muscle at the side of the pelvis, lifting it towards a shortened ureter so the two join without tension.
Why was my ureter injured during another operation?
The ureter runs close to the womb, bowel and major blood vessels, so it can be injured during pelvic or abdominal surgery even with care. Re-implantation is a recognised way to repair it.
Will my child need a catheter after surgery?
Most children have a urinary catheter for a short time after ureteric re-implantation, to rest the bladder while it heals. The team removes it once your child is comfortable.
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