Urinary Tract Reconstruction


General

Urinary tract reconstruction typically refers to reconstruction of the urinary tract drainage system (i.e. ureters, bladder, urethra).

Urinary tract reconstruction is performed for various reasons, but is typically due to a need for removing part of the urinary tract (i.e. cancer of the urinary tract or a different type of cancer which is closely associated with the urinary tract) or a need to revise a portion of the urinary tract due to poor function.


Types of reconstruction offered

  • Ureteral reconstruction due to conditions where the ureter is affected by either tumor, scar tissue, or other situation where the ureter is poorly or non-functional
    • Ureteral reimplantation

      —surgically reattaching healthy, unobstructed ureter to the bladder

    • Boari flap

      —Use of a bladder flap to replace lower portions of dysfunctional ureter

    • Ileal ureter

      —Use of small intestine to replace portions of dysfunctional ureter. Can be used to replace ureter all the way up to the kidney.

  • Bladder Reconstruction:
    • Conduit

      —Use of small or large intestine to replace the bladder. The segment of intestine is attached to the ureters draining the kidneys on one end and its opposite end is brought through the abdominal wall as a conduit. Urine drains from the end of the conduit into a bag called an ostomy. Type of conduit that we typically perform is an ileal conduit.

    • Continent catheterizable pouch

      —Use of large and small intestine to create an internal pouch capable of storing urine. The pouch is attached to the ureters draining the kidneys and it is drained by passing a catheter through the stoma of a continent conduit of bowel traversing the abdominal wall. The type of continent catheterizable pouch that we typically perform is an Indiana pouch.

    • Orthotopic neobladder

      —Use of small intestine to create an internal pouch capable of storing urine. The pouch is attached to the ureters draining the kidneys and it is connected to the remaining portion of the urethra. The urethral sphincter acts as the pouch’s continence mechanism. Patients are typically able to urinate in the standard fashion. However, some patients require catheterization of the pouch via the urethra due to difficulty in emptying the pouch. Other patients have issues with incontinence of urine for various reasons. Incontinence is most common at night-time, but can occur during the day as well. The type of neobladder we typically perform is a Studer pouch.

Male urinary tract in detail

About Urinary Tract Obstruction

General
Types of reconstruction offered