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Wednesday, April 16, 2014
Urinary and Genital Disorders (Children)
Can 2nd ureter reimplantation resolve issue?
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?
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.
Jack S Elder, MD, FACS, FAAP
Clinical Professor of Urology
School of Medicine
Case Western Reserve University