https://wikianesthesia.org/w/index.php?action=history&feed=atom&title=Ureteral_Re-ImplantationUreteral Re-Implantation - Revision history2026-08-24T14:28:59ZRevision history for this page on the wikiMediaWiki 1.37.1https://wikianesthesia.org/w/index.php?title=Ureteral_Re-Implantation&diff=18477&oldid=prevDominicmangino: Basic start to ureteral re-implantation2026-08-23T17:46:35Z<p>Basic start to ureteral re-implantation</p>
<p><b>New page</b></p><div>Ureteral reimplantation (ureteroneocystostomy) is a surgical procedure in which the ureter is detached from its native insertion into the bladder and re-anastomosed at a new site in the bladder wall. Typically used to treat severe vesicoureteral reflux. <br />
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'''Anesthetic Considerations:''' <br />
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Length: 2-4 hours but duration can vary significantly<br />
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'''GA with ETT + caudal vs''' <br />
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'''Analgesia''': Epidural or caudal analgesia is frequently used. Pain sources are abdominal incision (mediated by T11-L2) as well as visceral blader spasm (mediated by S2-S4 parasympathetic + T11-L2 sympathetic fibers)<br />
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Some evidence suggesting caudal catheter is the superior technique over high lumbar epidurals thought to be due to better sacral coverage. <ref>{{Cite journal|last=Sommerfield|first=David|last2=Ramgolam|first2=Anoop|last3=Barker|first3=Andrew|last4=Bergesio|first4=Ric|last5=von Ungern‐Sternberg|first5=Britta S|date=2016-04-07|title=Epidural insertion height for ureteric reimplant surgery; does location matter?|url=https://login.proxy1.library.jhu.edu/login?qurl=https://doi.org%2f10.1111%2fpan.12895|journal=Pediatric Anesthesia|volume=26|issue=10|pages=951–959|doi=10.1111/pan.12895|issn=1155-5645}}</ref><br />
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Ketorolac very effective in reducing postoperative bladder spasm.<ref>{{Cite journal|last=Park|first=John M.|last2=Houck|first2=Constance S.|last3=Sethna|first3=Navil F.|last4=Sullivan|first4=Lorna J.|last5=Atala|first5=Anthony|last6=Borer|first6=Joseph G.|last7=Cilento|first7=Bartley G.|last8=Diamond|first8=David A.|last9=Peters|first9=Craig A.|last10=Retik|first10=Alan B.|last11=Bauer|first11=Stuart B.|date=2000-07|title=Ketorolac Suppresses Postoperative Bladder Spasms After Pediatric Ureteral Reimplantation:|url=https://www.ovid.com/00000539-200007000-00003|journal=Anesthesia & Analgesia|language=en|volume=91|issue=1|pages=11–15|doi=10.1097/00000539-200007000-00003|issn=0003-2999}}</ref><br />
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'''Access:''' 1 -2 PIV <br />
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'''Maintenance:''' inhalational or TIVA appropriate<br />
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'''Neuromuscular blockade:''' as needed<br />
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'''Blood loss:''' In children typically minima 0 to 50ccl. Adults more substantial 5 to 500cc</div>Dominicmangino