Skip to main content

Techniques of Ureteral Reimplantation

  • Living reference work entry
  • First Online:
Female Genitourinary and Pelvic Floor Reconstruction
  • 109 Accesses

Abstract

Ureteral reimplantation (ureteroneocystostomy) is a reconstructive operation during which the distal ureter is reimplanted into the bladder. The most common indications for this surgery are ureteral obstruction, trauma, and vesicoureteral reflux. A basic understanding of ureteral reimplantation is crucial as the surgery is often performed on an urgent or emergent basis. The surgery may be performed via an open, laparoscopic, or robotic approach, and further characterized by an intra- or extravesical approach. A key additional feature is whether a refluxing or anti-refluxing anastomosis is performed. There is limited data on head-to-head comparisons among individual techniques and ultimately the choice is dependent on patient factors, surgeon experience, and the clinical scenario. Relatively few robust studies have been performed in the adult population, and much of the data are extrapolated from the pediatric literature.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Institutional subscriptions

References

  1. Byun S-S, Kim JH, Oh S-J, Kim HH. Simple retrograde balloon dilation for treatment of ureteral strictures: etiology-based analysis. Yonsei Med J. 2003;44(2):273–8.

    Article  PubMed  Google Scholar 

  2. Richter F, Irwin RJ, Watson RA, Lang EK. Endourologic management of benign ureteral strictures with and without compromised vascular supply. Urology. 2000;55(5):652–7.

    Article  CAS  PubMed  Google Scholar 

  3. Hafez KS, Wolf JS. Update on minimally invasive management of ureteral strictures. J Endourol. 2003;17(7):453–64.

    Article  PubMed  Google Scholar 

  4. Lucas JW, Ghiraldi E, Ellis J, Friedlander JI. Endoscopic management of ureteral strictures: an update. Curr Urol Rep. 2018;19(4):24.

    Article  PubMed  Google Scholar 

  5. Hurtado E, McCrery R, Appell R. The safety and efficacy of ethylene vinyl alcohol copolymer as an intra-urethral bulking agent in women with intrinsic urethral deficiency. Int Urogynecol J Pelvic Floor Dysfunct. 2007;18(8):869–73.

    Article  PubMed  Google Scholar 

  6. Kirchin V, Page T, Keegan PE, Atiemo KO, Cody JD, McClinton S, et al. Urethral injection therapy for urinary incontinence in women. Cochrane Database Syst Rev. 2017;25(7):CD003881.

    Google Scholar 

  7. Kalisvaart JF, Scherz HC, Cuda S, Kaye JD, Kirsch AJ. Intermediate to long-term follow-up indicates low risk of recurrence after double HIT endoscopic treatment for primary vesico-ureteral reflux. J Pediatr Urol. 2012;8(4):359–65.

    Article  PubMed  Google Scholar 

  8. Leung L, Chan IHY, Chung PHY, Lan LCL, Tam PKH, Wong KKY. Endoscopic injection for primary vesicoureteric reflux: predictors of resolution and long term efficacy. J Pediatr Surg. 2017;52(12):2066–9.

    Article  PubMed  Google Scholar 

  9. Rao KL, Menon P, Samujh R, Mahajan JK, Bawa M, Malik MA, et al. Endoscopic management of vesicoureteral reflux and long-term follow-up. Indian Pediatr. 2018;55(12):1046–9.

    Article  PubMed  Google Scholar 

  10. Kaye JD, Srinivasan AK, Delaney C, Cerwinka WH, Elmore JM, Scherz HC, et al. Clinical and radiographic results of endoscopic injection for vesicoureteral reflux: defining measures of success. J Pediatr Urol. 2012;8(3):297–303.

    Article  PubMed  Google Scholar 

  11. Kim D. Atlas of laparoscopic and robotic urologic surgery: Laparoscopic/Robotic Boari Flap Ureteral Reimplantation. Elsevier; 2017. p. 204–16.

    Google Scholar 

  12. Kaplan-Marans E, Fulla J, Tomer N, Bilal K, Palese M. Indocyanine Green (ICG) in urologic surgery. Urology. 2019;132:10–7.

    Article  PubMed  Google Scholar 

  13. Kanabur P, Chai C, Taylor J. Use of Indocyanine green for intraoperative ureteral identification in nonurologic surgery. JAMA Surg. 2020;155(6):520–1.

    Article  PubMed  Google Scholar 

  14. Slawin J, Patel NH, Lee Z, Dy GW, Kim D, Asghar A, et al. Ureteral reimplantation via robotic nontransecting side-to-side anastomosis for distal ureteral stricture. J Endourol. 2020;34(8):836–9.

    Article  PubMed  Google Scholar 

  15. Defoor WR. New contralateral vesicoureteral reflux-is it double trouble? J Urol. 2014;191(2):291–2.

    Article  PubMed  Google Scholar 

  16. Paquin AJ. Ureterovesical anastomosis: the description and evaluation of a technique. J Urol. 1959;82:573–83.

    Article  PubMed  Google Scholar 

  17. Kalayeh K, Brian Fowlkes J, Schultz WW, Sack BS. The 5:1 rule overestimates the needed tunnel length during ureteral reimplantation. Neurourol Urodyn. 2021;40(1):85–94.

    Article  PubMed  Google Scholar 

  18. Cohen SJ. The Cohen reimplantation technique. Birth Defects Orig Artic Ser. 1977;13(5):391–5.

    CAS  PubMed  Google Scholar 

  19. Politano VA, Leadbetter WF. An operative technique for the correction of vesicoureteral reflux. J Urol. 1958;79(6):932–41.

    Article  CAS  PubMed  Google Scholar 

  20. Gill IS, Ponsky LE, Desai M, Kay R, Ross JH. Laparoscopic cross-trigonal Cohen ureteroneocystostomy: novel technique. J Urol. 2001;166(5):1811–4.

    Article  CAS  PubMed  Google Scholar 

  21. Baek M, Han DH. Transvesicoscopic Politano-Leadbetter ureteral reimplantation in children with vesicoureteral reflux: a novel surgical technique. Investig Clin Urol. 2019;60(5):405–11.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Gil-Vernet JM. A new technique for surgical correction of vesicoureteral reflux. J Urol. 1984;131(3):456–8.

    Article  CAS  PubMed  Google Scholar 

  23. Simforoosh N, Radfar MH. Current status of Gil-Vernet trigonoplasty technique. Adv Urol. 2008;2008:536428.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Tatlişen A, Ekmekçioğlu O. Direct nipple ureteroneocystostomy in adults with primary obstructed megaureter. J Urol. 2005;173(3):877–80.

    Article  PubMed  Google Scholar 

  25. Sriram K, Babu R. Extravesical (modified Gregoir Lich) versus intravesical (Cohen’s) ureteric reimplantation for vesicoureteral reflux in children: a single center experience. Indian J Urol. 2016;32(4):306–9.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Silay MS, Turan T, Kayalı Y, Başıbüyük İ, Gunaydin B, Caskurlu T, et al. Comparison of intravesical (Cohen) and extravesical (Lich-Gregoir) ureteroneocystostomy in the treatment of unilateral primary vesicoureteric reflux in children. J Pediatr Urol. 2018;14(1):65.e1–4.

    Article  PubMed  Google Scholar 

  27. Schwentner C, Oswald J, Lunacek A, Deibl M, Koerner I, Bartsch G, et al. Lich-Gregoir reimplantation causes less discomfort than Politano-Leadbetter technique: results of a prospective, randomized, pain scale-oriented study in a pediatric population. Eur Urol. 2006;49(2):388–95.

    Article  CAS  PubMed  Google Scholar 

  28. McMann LP, Joyner BD. Outcomes of extravesical versus intravesical ureteral reimplantation. ScientificWorldJournal. 2004;4:195–7.

    Article  PubMed  PubMed Central  Google Scholar 

  29. Fung LC, McLorie GA, Jain U, Khoury AE, Churchill BM. Voiding efficiency after ureteral reimplantation: a comparison of extravesical and intravesical techniques. J Urol. 1995;153(6):1972–5.

    Article  CAS  PubMed  Google Scholar 

  30. Barrieras D, Lapointe S, Reddy PP, Williot P, McLorie GA, Bägli D, et al. Urinary retention after bilateral extravesical ureteral reimplantation: does dissection distal to the ureteral orifice have a role? J Urol. 1999;162(3 Pt 2):1197–200.

    CAS  PubMed  Google Scholar 

  31. Koyle MA, Butt H, Lorenzo A, Mingin GC, Elder JS, Smith GHH. Prolonged urinary retention can and does occur after any type of ureteral reimplantantion. Pediatr Surg Int. 2017;33(5):623–6.

    Article  PubMed  Google Scholar 

  32. Esposito C, Varlet F, Riquelme MA, Fourcade L, Valla JS, Ballouhey Q, et al. Postoperative bladder dysfunction and outcomes after minimally invasive extravesical ureteric reimplantation in children using a laparoscopic and a robot-assisted approach: results of a multicentre international survey. BJU Int. 2019;124(5):820–7.

    Article  PubMed  Google Scholar 

  33. Heidenreich A, Ozgur E, Becker T, Haupt G. Surgical management of vesicoureteral reflux in pediatric patients. World J Urol. 2004;22(2):96–106.

    Article  PubMed  Google Scholar 

  34. Lapointe SP, Barrieras D, Leblanc B, Williot P. Modified Lich-Gregoir ureteral reimplantation: experience of a Canadian center. J Urol. 1998;159(5):1662–4.

    Article  CAS  PubMed  Google Scholar 

  35. Baek M, Koh CJ. Lessons learned over a decade of pediatric robotic ureteral reimplantation. Investig Clin Urol. 2017;58(1):3–11.

    Article  PubMed  PubMed Central  Google Scholar 

  36. Kurtz MP, Leow JJ, Varda BK, Logvinenko T, Yu RN, Nelson CP, et al. Robotic versus open pediatric ureteral reimplantation: costs and complications from a nationwide sample. J Pediatr Urol. 2016;12(6):408.e1–6.

    Article  PubMed  Google Scholar 

  37. Boysen WR, Akhavan A, Ko J, Ellison JS, Lendvay TS, Huang J, et al. Prospective multicenter study on robot-assisted laparoscopic extravesical ureteral reimplantation (RALUR-EV): outcomes and complications. J Pediatr Urol. 2018;14(3):262.e1–6.

    Article  PubMed  Google Scholar 

  38. Barry JM. Unstented extravesical ureteroneocystostomy in kidney transplantation. J Urol. 1983;129(5):918–9.

    Article  CAS  PubMed  Google Scholar 

  39. Zaontz MR, Maizels M, Sugar EC, Firlit CF. Detrusorrhaphy: extravesical ureteral advancement to correct vesicoureteral reflux in children. J Urol. 1987;138(4 Pt 2):947–9.

    Article  CAS  PubMed  Google Scholar 

  40. Mesrobian HG, Kramer SA, Kelalis PP. Reoperative ureteroneocystostomy: review of 69 patients. J Urol. 1985;133(3):388–90.

    Article  CAS  PubMed  Google Scholar 

  41. Guney D, Tiryaki TH. The prevalence of redo-ureteroneocystostomy and associated risk factors in pediatric vesicoureteral reflux patients treated with ureteroneocystostomy. Urol J. 2019;16(1):72–7.

    PubMed  Google Scholar 

  42. Jung C, DeMarco RT, Lowrance WT, Pope JC, Adams MC, Dietrich MS, et al. Subureteral injection of dextranomer/hyaluronic acid copolymer for persistent vesicoureteral reflux following ureteroneocystostomy. J Urol. 2007;177(1):312–5.

    Article  CAS  PubMed  Google Scholar 

  43. Carrillo Arroyo I, Fuentes Carretero S, Gómez Fraile A, Morante Valverde R, Tordable Ojeda C, Cabezalí BD. Technical challenges of endoscopic treatment for vesicoureteral reflux after Cohen reimplantation. Actas Urol Esp. 2019;43(7):384–8.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Diana Bowen .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2023 Springer Nature Switzerland AG

About this entry

Check for updates. Verify currency and authenticity via CrossMark

Cite this entry

Lai, A., Jones, R., Chen, G., Bowen, D. (2023). Techniques of Ureteral Reimplantation. In: Martins, F.E., Holm, H.V., Sandhu, J., McCammon, K.A. (eds) Female Genitourinary and Pelvic Floor Reconstruction. Springer, Cham. https://doi.org/10.1007/978-3-030-71112-2_52-1

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-71112-2_52-1

  • Received:

  • Accepted:

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-71112-2

  • Online ISBN: 978-3-030-71112-2

  • eBook Packages: Springer Reference MedicineReference Module Medicine

Publish with us

Policies and ethics