Dr. med. Dirk Manski

 You are here: Urology Textbook > Surgery (procedures) > Ureteroureterostomy

Ureteroureterostomy: Surgical Technique and Complications

Ureteroureterostomy is the end-to-end anastomosis of the ureter, which is possible with open surgery, laparoscopy or robotic-assisted laparoscopy (Elliot and McAninch, 2006).

fig. ureteroureterostomy: end-to-end ureter anastomosis
Ureteroureterostomy: both ends of the ureter are spatulated. After placement of corner sutures, the anastomosis is done in a running or interrupted fashion.

Indication for Ureteroureterostomy


Surgical Technique of Ureteroureterostomy

Preoperative Patient Preparation

Surgical Approach

The surgical approach to the proximal ureter is via a flank incision. The mid-ureter and distal ureter are reached with a retroperitoneal or transperitoneal lower abdomen incision: e.g., paramedian laparotomy or Gibson incision. A laparoscopic (robotic-assisted) approach is also possible, depending on previous operations. After identification, the ureter is marked with a vessel loop, followed by mobilization cranial and caudal to the stricture. It is essential to treat the ureter atraumatically and to spare its vascular supply.

Anastomosis of the Ureter:

Postoperative Care after Ureterureterostomy

General measures:

Early mobilization, respiratory therapy, thrombosis prophylaxis, laboratory tests (hemoglobin, creatinine), regular physical examination of the abdomen and incision wound.


With a combination of NSAIDs and opioids, a peridural anesthesia facilitates postoperative pain management.

Drains and catheters:

The retroperitoneal drainage is removed if the daily drainage volume is well below 50 ml, Bladder catheter additional 1–2 days or 3–5 day in total, ureteral stent 2–4 weeks.

Complications of Ureteroureterostomy

Bleeding, infection, urinoma, recurrent ureteral stricture, loss of kidney function, injury to adjacent organs (liver, spleen, pancreas).

Index: 1–9 A B C D E F G H I J K L M N O P Q R S T U V W X Y Z


Elliott, S. P. & McAninch, J. W. Ureteral injuries: external and iatrogenic
Urol Clin North Am, 2006, 33, 55-66, vi

  Deutsche Version: Ureteroureterostomie