What is ureteral reimplant surgery?

A ureteral (say "you-REE-tur-ul") reimplant is surgery to change the way a ureter connects to the bladder. The ureter is the tube that carries urine from the kidney to the bladder.

When a ureter does not connect to the bladder correctly, urine can go backward from the bladder into the kidney. This can cause infections and kidney damage. Surgery helps prevent these problems.

Your child will be asleep during the surgery. First, the doctor makes a cut in your child's lower belly. This cut is called an incision. Then the doctor takes the ureter out of the bladder. Next, he or she connects it in a different place so urine cannot go backwards into the kidneys. Then the doctor closes the incision with stitches. The incision leaves a scar that usually fades with time.

Most children go home 2 to 4 days after surgery.

Activity

• Allow your child to slowly become more active. Have your child rest as much as needed. Make sure your child gets enough sleep at night.
• If your child is old enough to walk, have them try to walk each day. Bit by bit, increase the amount your child walks. Your child may climb stairs. Walking boosts blood flow and helps prevent pneumonia and constipation.
• Your child may take a shower or bath, unless your child still has a urinary catheter or drain. If your child has a catheter or drain, follow your doctor's instructions about bathing.
• If your child goes to school or day care, they may return when they are ready. This is usually in about 1 to 2 weeks.
• Do not allow your child to do strenuous activity for about 4 to 6 weeks, or until your doctor says it is okay. This includes riding bikes, playing running games, wrestling, and taking part in gym class.
• Do not allow your child to swim or go in hot tubs until the doctor says it is okay.
• Your child may ride in the car with the car seat straps in their usual position.

Diet

• Your child can eat a normal diet. If your child's stomach is upset, try bland, low-fat foods like plain rice, broiled chicken, toast, and yogurt.
• Have your child drink plenty of fluids.
• You may notice a change in your child's bowel habits right after surgery. This is common. If your child has not had a bowel movement after a couple of days, call the doctor.

Medicines

• Your doctor will tell you if and when your child can restart any medicines. The doctor will also give you instructions about your child taking any new medicines.
• The doctor may give your child medicine for bladder spasms. Have your child take it as directed.
• Make sure that your child takes pain medicines exactly as directed.
  • If the doctor gave your child a prescription medicine for pain, give it as prescribed.
  • If your child is not taking a prescription pain medicine, ask the doctor if your child can take an over-the-counter medicine.
• If you think pain medicine is making your child sick to their stomach:
  • Give your child the medicine after meals (unless the doctor has told you not to).
  • Ask your child's doctor for a different pain medicine.
• Your doctor may prescribe antibiotics. Have your child take them as directed. Do not stop giving them just because your child feels better. Your child needs to take the full course of antibiotics.

Incision care

• If your child has strips of tape on the incision, leave the tape on for a week or until it falls off.
• Wash the area daily with warm, soapy water, and pat it dry. Don't use hydrogen peroxide or alcohol, which can slow healing. You may cover the area with a gauze bandage if it weeps or rubs against clothing. Change the bandage every day.
• Keep the area clean and dry.

Other instructions

• Your child may have a urinary catheter or a drain near the incision. Your doctor will tell you how to take care of it.
• Your child may not be able to control when they urinate for a few weeks. Your child may need a diaper or pad to soak up leaking urine for 2 to 3 weeks. Reassure your child that this often happens after the surgery and will stop in time.

Surgery can be stressful for both your child and you. This information will help you understand what you can expect. And it will help you safely prepare for your child's surgery.

Preparing for surgery

• Talk to your child about the surgery. Tell your child that the surgery will help make your child's bladder healthier. Hospitals know how to take care of children. The staff will do all they can to make it easier for your child.
• Ask if a special tour of the surgery area and hospital is available. This may make your child feel less nervous about what happens.
• Plan for your child's recovery time. Your child may need more of your time right after the surgery, both for care and for comfort.
• Understand exactly what surgery is planned, along with the risks, benefits, and other options.
• Tell the doctor ALL the medicines, vitamins, supplements, and herbal remedies your child takes. Some may increase the risk of problems during the surgery. Your doctor will tell you if your child should stop taking any of them before the surgery and how soon to do it.

The day before surgery

• A nurse may call you (or you may need to call the hospital). This is to confirm the time and date of your child's surgery and answer any questions.
• Remember to follow your doctor's instructions about your child taking or stopping medicines before surgery. This includes over-the-counter medicines.

A ureteral (say "you-REE-tur-ul") reimplant is surgery to change the way a ureter is attached to the bladder. The ureter is the tube that carries urine from the kidney to the bladder.

After surgery, your child may need to urinate more often or may feel a sudden need to urinate. Your child also may have a burning feeling when they urinate. You may notice some blood in your child's urine. Your child may have bladder cramps (spasms) while the bladder is healing. This can hurt. Your doctor can give your child medicine to help with pain. These symptoms usually get better in 2 to 4 weeks.

Your child may have a tube that drains urine from the bladder (urinary catheter). Your child also may have a tube near the incision to drain fluids at first.

After surgery, your child may have fewer urinary tract infections. This surgery also may help prevent kidney damage that can happen when urine keeps backing up into the kidneys.

Most children are able to go back to school or day care in about 1 to 2 weeks.

• Follow the instructions exactly about when your child should stop eating and drinking. If you don't, the surgery may be canceled. If the doctor told you to have your child take his or her medicines on the day of surgery, have your child take them with only a sip of water.
• Have your child take a bath or shower before you come in. Do not apply lotion or deodorant.
• Your child may brush his or her teeth. But tell your child not to swallow any toothpaste or water.
• Do not let your child wear contact lenses. Bring your child's glasses or contact lens case.
• Be sure your child has something that reminds him or her of home. A special stuffed animal, toy, or blanket may be comforting. For an older child, it might be a book or music.

At the hospital or surgery center

• A parent or legal guardian must accompany your child.
• Your child will be kept comfortable and safe by an anesthesia provider. Your child will be asleep during the surgery.
• The surgery will take 2 to 4 hours.
• After surgery, your child will be taken to the recovery room. As your child wakes up, the recovery room staff will monitor his or her condition. The doctor will talk to you about the surgery.
• Your child will have a tube that drains urine from his or her bladder. This is called a urinary catheter.
• Your child will have a tube near the incision to drain fluids.
• You will probably be able to take your child home in 2 to 4 days.