✦ Ureteral Obstruction Treatment

Open Ureteroureterostomy

Q: When is open ureteroureterostomy preferred over laparoscopic?

Open is preferred for immediate intraoperative injury repair, dense adhesions from previous surgery, and complex cases requiring tactile feedback.

Q: Can an injured ureter be repaired immediately?

Yes — immediate repair at the time of recognition gives the best outcomes; delayed repair (after stenting) is performed if injury is identified late.

Q: What if the ureteral ends cannot be joined without tension?

Psoas hitch, Boari flap, or ileal interposition is used to bridge the gap when tension-free end-to-end anastomosis is not achievable.

Open Surgical End-to-End Ureteral Repair for Stricture or Injury

90–150 min PROCEDURE

3–5 Days HOSPITAL STAY

>90% SUCCESS RATE

4–6 Weeks RECOVERY

What is Open Ureteroureterostomy?

Open Ureteroureterostomy is the classic surgical anastomosis of the divided or strictured ureter through a flank or abdominal incision, providing direct vision and tactile feedback during the repair. It is preferred for complex cases, dense adhesions from prior surgery, iatrogenic ureteral injuries requiring immediate reconstruction, or when laparoscopic facilities are unavailable. Direct vision ensures accurate assessment of ureteral vascularity and tension. The procedure is performed under general or spinal anaesthesia with a hospital stay of 3–5 Days. Success rates reach >90% in appropriately selected patients at experienced centres.

Patients with ureteral stricture or injury requiring open reconstruction — including complex redo cases, intraoperative ureteral injuries, or dense retroperitoneal adhesions. Patients must be adequately fit for anaesthesia and free from active systemic infection before proceeding.

How the Procedure Works

Incision & Access

Flank or paramedian abdominal incision based on level of ureteral injury or stricture.

Ureteral Identification

Retroperitoneum opened; ureter identified and traced to the stricture or injury site.

Segment Excision

Diseased or injured segment excised; viable ends confirmed by bleeding from cut edges.

Anastomosis over Stent

Ends spatulated; tension-free anastomosis over DJ stent with absorbable sutures.

Drain & Closure

Drain placed adjacent to anastomosis; wound closed in layers.

Outcomes

90–150 minDURATION

3–5 DaysHOSPITAL STAY

>90%SUCCESS RATE

4–6 WeeksFULL RECOVERY

Who Needs This Treatment?

→Direct vision confirms viable ureteral ends before anastomosis.
→Tactile feedback in complex adhesions where laparoscopy is hazardous.
→Immediate repair of intraoperative ureteral injuries at the time of recognition.
→Equivalent success rate to laparoscopic approach (>90%).
→Allows simultaneous ureteral length augmentation if required.
→Preferred when laparoscopic expertise is unavailable.

"Open ureteroureterostomy gives us full control with direct vision and tactile sense. For complex ureteral injuries or redo strictures, nothing replaces the confidence of operating under open conditions."

— — Dr. Vipin Reddy, Consultant Urologist, Andrologist & Renal Transplant Surgeon

Common Questions

Frequently Asked

When is open ureteroureterostomy preferred over laparoscopic?+

Can an injured ureter be repaired immediately?+

What if the ureteral ends cannot be joined without tension?+

Not sure which treatment is right for you?

Book a consultation with Dr. Vipin Reddy and get a personalised treatment plan.

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