Robotic Ureteral Reimplantation

[Polaris1]

Have any of you had this surgery? How did it turn out?

My right ureter has a partial blockage that is believed to be radiation damage from my prostate cancer radiation treatments five years ago. The ureter is very narrow near the bladder, and urine flow is restricted. A surgeon at University of Chicago Medicine believes that ureter reconstruction is needed to prevent damage to my kidney (also to provide a path for the stones in my right kidney to come out or be taken out).

This surgery is called “Robotic Ureteral Reimplantation”. The surgeon will cut out the lower 5 cm of the ureter and reconnect the remaining section of ureter to the top of the bladder.

[Omalley]

I had the same problem, I had radiation in 2009 and in 2021 or so the VA found I had stones and a blocked left kidney, long story short after a bunch of stone surgeries both tubes were blocked and my kidneys were in danger of failing. My flow chart from before showed the left one at 20% and the right one at 80% but again after all the scopes both were blocked, not completely but backing up. I must have been guided by God anserwing my prayers. The VA was going to do the surgery but I was hesitant since the surgeon had not done very many of these operations. I just happened to Google the surgery and the name of a Dr. Jill Buckley came up as the guru of this kind of surgery. She was at UC San Diego, well the San Diego VA is kind of attached to UCSD, most of the VA doctors are from UCSD. but again they are interns in a lot of cases. I talked to my VA doctor about Dr. Buckley and he said he was one of her students and I should ask the VA to get me an appointment with her. I did and she said she could do it but first had to do some exploring. I went under and she put in two stents so the kidneys would drain while we were waiting. I had surgery scheduled for January of 2023 but someone else didn't want to have surgery before the holidays, I jumped at the chance to get it done sooner. Had sugary on Dec 11th 2022. Went well, she was able to cut off the bad parts and reattach the tubes without having to reconstruct anything. If reconstruction was necessary she would have used either my appendix or tissue from inside my mouth. I had a catheter for ten days, and stents for thirty. Had bleeding from the stents but after they came out I had 30 HBOT treatments to help healing I guess. Bottom line I'm fine, have to pee more often but other than that I couldn't be happier. You really have no choice you need to get it done just find a surgeon that knows what they are doing. Don't know where you live but if you're within a thousand miles of San Diego I'd check on Dr. Buckley. she is the guru of that surgery, people come from all over the Southwest to see her so sometimes she's hard to get but I was blessed in the way it worked out for me. I wish you the best, the thing is it's fixable and then you can go on with your life.

[Polaris1 in reply to Omalley]

Omalley, thank you for your helpful reply. Glad to hear the outcome has been good. The surgeon here at the University of Chicago appears to be quite experienced with this procedure, so I am hopeful it will be successful.

Nothing has been said to me about HBOT treatments. Please tell me more about this. Did your surgeon recommend this? Where did you have that done?

[CWT53 in reply to Polaris1]

I had uretral stenosis in November 2023 that required stents on both sides. It occurred after 3 doses of cabitaxel and 2 of docetaxel. I had to make several nightmarish trips to the emergency room before I got relief. Previous radiation had been received three years prior. I blamed the chemo but the MO wouldn’t buy it. After a month and a half the stents were removed and I have not had the problem again. No stones were ever found. Good luck on reconstructive surgery.

[Polaris1 in reply to CWT53]

Thanks. I have not had chemo. The doctor thinks my blockage may be from radiation five years ago, but they will find out when they remove the bad section of ureter and send it for pathology tests.

[Omalley in reply to Polaris1]

I knew about HBOT and since I had had bladder bleeding from the stents and knew my bladder was not good the UCSD doctors recommended it. I had it done locally, I live in a town of about 15,000 East of San Diego about 120 miles and there was a HBOT facility in my town plus another one in a town 15 miles away, my point is that it seems that it is pretty prevalent no matter where you are so you shouldn't have any trouble finding a facility but you have to get your doctor to prescribe it.

The treatments last about 90 minutes each and I had 30 of them. There are several different ways but the one I had seems to be the most common. You are put in a tube that is some kind of clear material so you can see out, they pump up to two atmospheres of pressure, your ears pop a lot but other than that it's painless. If you have cataracts it can affect them, I have them but it didn't seem to make them too much worse. It did seem to affect my vision some but it returned to normal when I was done. I highly recommend it, no bleeding since and from what I have read it is over 90% effective.

Also they have a TV you can watch, saw a whole bunch of Gunsmoke episodes, made me a fan of Gunsmoke.

You can Google it and see the machines and read about it.

[j-o-h-n]

Had many many stents (in and out) through the years..... (no problem with the ins and outs - trust me) in my left urinary tract. Finally we (doc and I) decided enough is enough and stopped them. Therefore I piss 15% from left and 85% from right and no issues now for many years. I say "if it works, don't fix it".....

Good Luck, Good Health and Good Humor.

j-o-h-n

[Polaris1 in reply to j-o-h-n]

Thanks for sharing your experience living with 15%/85% unbalance between left and right ureter urine flow!

I was very happy to learn today that my urine flow is 51% (left) and 49% (right) - very balanced compared to what the doctors expected with a partially blocked ureter on the right side. So surgery was cancelled, and we will re-check in six months.

[j-o-h-n]

Good news!!! But just a reminder, for me, in and out stents were a no burger burger.

Also, never say you're gonna take a piss, you don't want to take one, you want to leave one.....

Good Luck, Good Health and Good Humor.

j-o-h-n