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Ureteral Reimplantation (Ureteroneocystostomy)

Surgical reconstruction of the distal ureter into the bladder via antireflux tunnel for vesicoureteral reflux, distal ureteral stricture, or iatrogenic injury - performed via open, laparoscopic, or robotic approach.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Üroloji department. Book Appointment →

What is Ureteral Reimplantation (Ureteroneocystostomy)?

Ureteral reimplantation creates a tunneled antireflux mechanism between the ureter and bladder. Normal ureterovesical junction has 3-5:1 tunnel length-to-ureter ratio; this ratio is disrupted in VUR causing reflux. Reimplantation can be transvesical (Politano-Leadbetter, Cohen), extravesical (Lich-Gregoir), or combined (Glenn-Anderson). Ureteral mobilization preserves blood supply.

Indications: 1) Vesicoureteral reflux (VUR) - high-grade (IV-V), recurrent UTI, breakthrough infection, antibiotic prophylaxis failure, scar progression; 2) Distal ureteral stricture - obstetric/iatrogenic injury, radiation, inflammation; 3) Ureteral cancer - distal segment tumor; 4) Megaureter - obstructive or refluxing; 5) Ureteral fistula. Pediatric vs adult indications differ.

Surgical techniques and complications: Cohen (cross-trigonal) - gold standard for pediatric VUR, success >95%; Lich-Gregoir (extravesical) - shorter hospital stay, advantageous for unilateral; psoas hitch - additional length when distal ureter is short; Boari flap - very long defects. Long defects: ileal interposition. Complications: anastomotic leak (1-3%), persistent reflux (3-5%), de novo obstruction (1-2%), bladder dysfunction (10-15% bilateral procedure).

Symptoms

Recurrent urinary tract infection
Pyelonephritis attacks
Antenatal hydronephrosis
VUR-related kidney scar
Iatrogenic ureteral injury (post-cystectomy/hysterectomy)
Persistent flank pain

Risk Factors

Vesicoureteral reflux (high-grade)
Iatrogenic ureteral injury
Pelvic surgery history
Pelvic radiation
Distal ureteral cancer
Family history of VUR

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Recurrent UTI (>3 episodes/year)
  • Breakthrough infection on antibiotic prophylaxis
  • Kidney scar progression (DMSA)
  • Iatrogenic ureteral injury
  • Persistent obstructive uropathy
  • Pre-cystectomy ureteral evaluation

Treatment Methods

01
Cohen cross-trigonal (pediatric VUR gold standard)
02
Lich-Gregoir extravesical (preferred for unilateral)
03
Psoas hitch and Boari flap (long defects)
04
Robotic-assisted approach
05
JJ stent placement (4-6 weeks)
06
Postoperative VCUG (3-6 months)

Which Department to Visit?

You can visit our Üroloji department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.