Ileal replacement surgery was performed to eliminate the obstruction in ureter. This method is as safe as any other traditional treatments and blood transfusion is not necessary for this surgery.
Even in complex and difficult cases, urologist may suggest Ileal ureteric replacement because it was safe and consistent option. Ileal ureter reconstruction was recommended to the patients when other more conservative surgical treatments are not advisable.
For complete ureteral replacement, the proximal opening of the ileal segment was brought to the renal pelvis. The renal pelvis was widely opened to allow end-to-end anastomosis to the ileum. In case of small renal pelvis, it may be required to narrow the ileum it was done by closing the proximal opening of ileum incompletely on the antimesenteric side. The pyeloileal anastomosis is done in one layer with any interrupted sutures or running suture of 3-0 or 4-0 chromic catgut. Since a nephrostomy tube was already in place, it was not necessary to stent the ileal ureter.
PROCEDURE:
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Ureteric replacement by small intestine is usual, well established, useful and safe procedure and is no longer a surgical curiosity.
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Small intestine (ileum) is particularly preferable for reconstruction of long-segment ureteral strictures.
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Urologic doctor may select a proper part of the ileum which was then carried to the retroperitoneum by a small window in the colonic mesentery.
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This chosen portion of small intestine was joined (anatomized) with the renal pelvis and bladder by using full-thickness watertight sutures.
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The total time of the whole surgery will take about 3-4 hours.
Some of the risks or symptoms after the surgery may appears such as fever, slight bleeding after the operation, infection, urinary abnormalities, renal insufficiency, poor wound healing ( following open surgery), fatigue, Infection, lower body aches, bladder dysfunction, inflammatory bowel disease.
