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Urinary and Genital Disorders (Children)

Can 2nd ureter reimplantation resolve issue?

07/13/2010

Question:

My 11-year-old underwent a ureter reimplantation surgery in Dec. 2008 to resolve kidney reflux / infection. Follow up tests (ultrasound / IVP, etc.) -- May 2009 -- reflected improvement in appearance of kidney and ureter and my son appeared to be recovering well. About 2 - 3 months ago he began experiencing occasional abdominal pain, but it would subside. A check up in June 2010 -- with us / ivp -- revealed an inflamed ureter and kidney. Dr. immediately suggested reimplantation redo, but cannot clearly identify exact procedure or whether procedure will resolve problem. Is it `normal` to undergo repeat of this type of procedure and should it generally resolve the problem?

Answer:

This question is difficult to answer. In most children ureteral reimplantation is permanent and does not need to be repeated. However, occasionally a ureter becomes obstructed and needs a second procedure to correct the problem. Most often this occurs in children with bladder or bowel dysfunction. Usually the need for repeat surgery is apparent when the first follow-up ultrasound is done.

I am uncertain what you meant by 'inflamed ureter and kidney"--do you mean hydronephrosis? If so, then other radiologic studies might be necessary. If your son is not seeing a fulltime pediatric urologist, then it might be worthwhile having him see one. Also, before a repeat surgical procedure is done, it is important that you understand what the surgeon is planning to do and why.

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Response by:

Jack S Elder, MD, FACS, FAAP Jack S Elder, MD, FACS, FAAP
Clinical Professor of Urology
School of Medicine
Case Western Reserve University