Name of the Procedure:

Ureterectomy with Bladder Cuff (Separate Procedure)

Summary

A ureterectomy with bladder cuff is a surgical procedure that involves removing part or all of a ureter (the tube that carries urine from the kidney to the bladder) along with a cuff of bladder tissue. This is often done to treat cancers or other severe conditions affecting the ureter.

Purpose

The procedure addresses issues such as ureteral cancer, severe ureteral damage, or strictures. The goal is to remove the diseased portion of the ureter to prevent the spread of cancer or to resolve obstructions and other complications.

Indications

• Ureteral cancer
• Ureteral strictures or obstructions
• Severe trauma or damage to the ureter
• Recurrent kidney infections not responsive to other treatments

Preparation

• Fasting for at least 8 hours prior to the procedure
• Adjusting medications as advised by the healthcare provider
• Pre-operative imaging studies such as CT scans or MRIs
• Blood tests and urine tests

Procedure Description

1. The patient is placed under general anesthesia.
2. An incision is made in the abdomen to access the ureter.
3. The affected section of the ureter, along with a portion of the bladder tissue, is carefully removed.
4. Surrounding lymph nodes may also be removed for examination.
5. The remaining ureter is reconnected to the bladder (or other necessary reconstructive steps are taken).
6. The incision is closed with sutures or staples.
7. A catheter may be placed to help drain urine during initial recovery.

Duration

The procedure typically takes 2 to 4 hours, depending on the extent of the surgery.

Setting

The procedure is usually performed in a hospital operating room.

Personnel

• Surgeon (usually a urologist)
• Anesthesiologist
• Surgical nurses
• Scrub techs and other support staff

Risks and Complications

• Infection
• Bleeding
• Injury to surrounding organs or tissues
• Blood clots
• Urinary leakage or fistula formation
• Stricture or obstruction of the remaining ureter

Benefits

• Removal of cancerous tissues
• Relief from obstruction or strictures
• Prevention of further complications related to the ureteral condition
• Improved urinary function and reduction in recurrent infections

Recovery

• Hospital stay of 3 to 7 days post-surgery
• Regular monitoring for signs of infection or complications
• Avoid lifting heavy objects and strenuous activities for at least 4 to 6 weeks
• Follow-up appointments for progress assessment and removal of any drains or catheters

Alternatives

• Localized treatments (e.g., endoscopic procedures) for small, non-invasive tumors
• Chemotherapy or radiation for cancer
• Stents or other procedures for temporary relief of strictures
• Less invasive surgeries if applicable

Patient Experience

• Patients will be under general anesthesia during the procedure, so they will not experience pain at that time.
• Post-operatively, some pain and discomfort are expected, managed with pain medication.
• Initial difficulty in urination may occur due to the presence of a catheter.
• Gradual improvement in symptoms and healing over weeks to a few months.