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CPT4 code

Name of the Procedure:

Common name: Ureteral reimplantation


Ureteroureterostomy is a surgical procedure where one segment of the ureter is connected to another segment to bypass a damaged or obstructed part of the ureter. This operation allows urine to flow properly from the kidney to the bladder.


Medical condition or problem it addresses:

  • Ureteral obstruction
  • Ureteral injury
  • Ureteral strictures
  • Ureteral tumors

Goals or expected outcomes:

  • Restore normal urine flow
  • Relieve pain and discomfort
  • Prevent kidney damage


Symptoms or conditions warranting the procedure:

  • Recurrent urinary tract infections
  • Flank pain
  • Hematuria (blood in urine)
  • Hydronephrosis (swelling of a kidney due to urine build-up)

Patient criteria:

  • Evidence of ureteral obstruction via imaging
  • Failed conservative treatments (e.g., stents, medication)


Pre-procedure instructions:

  • Fasting for at least 8 hours prior to surgery
  • Adjustments to current medications, particularly blood thinners
  • Preoperative clearance from a primary care physician or a specialist if needed

Diagnostic tests or assessments:

  • Blood tests
  • Urine analysis
  • Imaging studies (e.g., CT scan, MRI, Ultrasound)

Procedure Description

  1. Anesthesia: The patient is placed under general anesthesia.
  2. Incision: A small incision is made in the abdomen or through minimally invasive laparoscopic techniques.
  3. Isolation: The surgeon isolates the affected segment of the ureter.
  4. Resection: The damaged or obstructed section is removed.
  5. Reconnection: The healthy ends of the ureter are then sutured together.
  6. Closure: The incision is closed with sutures or staples.

Tools and equipment:

  • Surgical sutures
  • Laparoscope (for minimally invasive approach)
  • Ureteral catheters


The procedure typically takes 2 to 3 hours.


Performed in a hospital operating room.


  • Urologist or specialized surgeon
  • Anesthesiologist
  • Surgical nurses
  • Operating room technicians

Risks and Complications

Common risks:

  • Infection
  • Bleeding
  • Urine leakage

Rare complications:

  • Ureteral stricture formation
  • Kidney dysfunction

Management of complications:

  • Antibiotics for infections
  • Additional surgical interventions if necessary


  • Restoration of normal urinary flow
  • Relief from symptoms such as pain and recurrent infections
  • Preservation of kidney function

Benefit realization:

  • Benefits are generally noticed shortly after recovery from surgery.


Post-procedure care:

  • Pain management with prescribed medications
  • Encouragement to maintain a small amount of physical activity to promote recovery

Expected recovery time:

  • Hospital stay of 2 to 3 days
  • Complete recovery within 4 to 6 weeks

Restrictions and follow-up:

  • Avoid heavy lifting and strenuous activities for at least 4 weeks
  • Follow-up appointments to monitor recovery and ensure the new ureter connection is functioning properly


Other treatment options:

  • Ureteral stent placement
  • Nephrostomy tube
  • Endoscopic ureteral dilation

Pros and cons of alternatives:

  • Ureteral stent: Less invasive but may require frequent replacements.
  • Nephrostomy tube: Diverts urine externally, affecting quality of life.
  • Endoscopic dilation: Minimally invasive but less effective for severe obstructions.

Patient Experience

During the procedure:

  • The patient will be under general anesthesia and will not feel anything.

After the procedure:

  • Some pain and discomfort at the incision site
  • Possible need for a catheter temporarily
  • Pain management through medications to ensure comfort

Pain management and comfort measures:

  • Prescription pain relievers
  • Ice packs to minimize swelling
  • Encouraging adequate hydration

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