✦ Ureteral Obstruction Treatment

Ureteroplasty / Ureteric Reimplantation

Q: What is a Boari flap?

A Boari flap uses a tubularised strip of bladder wall to bridge a mid-ureteral defect, bringing the ureter to the bladder when direct reimplantation would be under tension.

Q: What is ileal ureteral substitution?

For very long ureteral defects, a segment of ileum is used to replace the ureter — a major but effective reconstructive option.

Q: How long is hospitalisation after ureteroplasty?

Hospital stay is 3–5 days; the DJ stent remains for 4–6 weeks; return to normal activities takes 4–6 weeks.

Surgical Reconstruction of the Obstructed Ureter

120–240 min PROCEDURE

3–5 Days HOSPITAL STAY

>85% SUCCESS RATE

4–6 Weeks RECOVERY

What is Ureteroplasty / Ureteric Reimplantation?

Ureteroplasty and Ureteric Reimplantation surgically reconstruct the obstructed ureter to restore normal drainage. The approach depends on the level and cause of obstruction: short strictures may be excised and ends rejoined; mid-ureteral defects may require Boari flap or psoas hitch reimplantation; long defects may need ileal ureteral substitution. These procedures are performed for benign or iatrogenic ureteral strictures, traumatic injuries, and failed prior endoscopic treatment. The procedure is performed under general or spinal anaesthesia with a hospital stay of 3–5 Days. Success rates reach >85% in appropriately selected patients at experienced centres.

Patients with ureteral strictures not suitable for endoscopic management, post-radiation ureteral stenosis, iatrogenic ureteral injuries, or failed prior stenting. Patients must be adequately fit for anaesthesia and free from active systemic infection before proceeding.

How the Procedure Works

Approach Selection

Open or laparoscopic/robotic approach selected based on level and extent of stricture.

Anatomical Identification

Diseased ureteral segment identified and assessed; blood supply evaluated.

Stricture Excision

Stricture excised; anastomosis technique selected based on defect length.

Reconstruction

Short defects: end-to-end ureteroureterostomy. Long defects: Boari flap, psoas hitch, or ileal ureteral substitution.

Stent & Closure

DJ stent placed; drain inserted; incision or ports closed.

Outcomes

120–240 minDURATION

3–5 DaysHOSPITAL STAY

>85%SUCCESS RATE

4–6 WeeksFULL RECOVERY

Who Needs This Treatment?

→Definitively corrects obstructing ureteral strictures resistant to endoscopic management.
→Multiple reconstructive options match the technique to the defect length.
→Eliminates long-term stent dependency in benign obstruction.
→Suitable for post-radiation and post-surgical strictures.
→Robotic and laparoscopic approaches reduce morbidity vs open surgery.
→Psoas hitch and Boari flap techniques bridge significant ureteral defects.

"Ureteric reconstruction demands creativity and technical versatility. Whether it is a simple anastomosis or a Boari flap, we match the technique to the defect and restore drainage that lasts a lifetime."

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

Common Questions

Frequently Asked

What is a Boari flap?+

What is ileal ureteral substitution?+

How long is hospitalisation after ureteroplasty?+

Not sure which treatment is right for you?

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