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UPJ and Reconstruction

Why choose HackensackUMC Urology

The urologists at Hackensack University Medical Center are world-renowned in the treatment of ureteral stricture, a condition characterized by the narrowing of the tube that carries urine from the kidneys to the bladder. We treat the most common type of ureteral stricture, known as ureteropelvic junction (UPJ) obstruction, and more complex ureteral strictures, including proximal and mid-ureteral strictures.

For over a decade our surgeons have used robotic surgery to treat ureteral stricture. They are pioneers in developing innovative robotic surgical techniques, including:

  • A specialized procedure for extensive stricture that uses tissue from another part of the body, such as the inside of the mouth, to reconstruct the ureter
  • The use of enhanced imaging techniques during surgery to make sure there is healthy tissue being reconnected
  • Ureterolysis, a procedure to remove a mass of tissue or scar tissue that is pressing on one or both ureters known as retroperitoneal fibrosis
  • Ureterocalicostomy, a procedure that removes the obstructed section of the ureter and reattaches the ureter to the bottom of the kidney

Experts You Can Trust

HackensackUMC urologists are known throughout the world for their expertise in ureteral stricture surgery.

HackensackUMC Urology - UPJ and Reconstruction

Diagnosis of Ureteral Stricture

Ureteral stricture can be caused by kidney stones, fibrosis, or scarring after surgery or radiation. It may also be congenital, or present since birth. Your treatment plan will be determined by the location, extent and cause of your stricture.

Your doctor will perform a thorough medical exam and may recommend diagnostic tests such as an ultrasound, CT scan, MRI, renal scan or a retrograde ureteroscopy (used to see if there is a blockage in your urinary tract). These tests help identify the cause and extent of your condition. Your doctor uses the results to determine the best approach to your treatment.

Published Surgeons

Outcomes of robotic-assisted laparoscopic upper urinary tract reconstruction: 250 consecutive patients.

Surgical Approaches for Ureteral Stricture in Adults

At HackensackUMC, more than 90 percent of procedures to correct ureteral strictures are performed robotically. This approach often results in less bleeding, less scarring and a lower infection rate than conventional surgery. It can also lead to a shorter recovery time in the hospital.

 

Techniques We Use

Our physicians are expert in the most innovative techniques to repair simple to complex ureteral conditions.

Robotic pyeloplasty. When the narrowing occurs at the ureteropelvic junction (UPJ) where the kidney meets the ureter, doctors remove the blockage and the ureter is surgically reconstructed. This also helps to prevent future problems.

Buccal mucosa ureteroplasty. When the UPJ or top of the ureter (proximal ureter) is so scarred that a pyeloplasty cannot be performed, doctors may use an approach known as a buccal mucosa ureteroplasty (a technique pioneered by HackensackUMC surgeons), which allows them to rebuild the ureter using tissue from the inside of the cheek.

Ureterocalicostomy. This procedure involves removing the bottom of the kidney and attaching the ureter to the inner part of the kidney where urine forms and collects.

Ureteroureterostomy. When the blockage occurs in the top or middle section of the ureter, a ureteroureterostomy may be necessary. During this procedure, the doctor removes the obstructed area and connects the remaining portions of the ureter together. If the stricture is small enough, a laser may be used to cut the stricture without the need for robotic surgery.

Ureteral reimplantation. When there is an obstruction in the bottom portion of the ureter where it meets the bladder, the surgeon performs ureteral reimplantation. He or she removes the ureter directly above the blockage and implants it into another part of the bladder. To do so, the surgeon creates a new opening in the bladder and attaches the end of the ureter to this opening.



Physicians in this Specialty

MUTAHAR AHMED, M.D.


MICHAEL ESPOSITO, M.D.


GREGORY LOVALLO, M.D.


RAVI MUNVER, M.D.


MICHAEL STIFELMAN, M.D.


JEFFREY STOCK, M.D.




Get Connected to HackensackUMC Urology Department

Learn more about our team of specialists

Meet Our Team

To make an appointment, contact a HUMG Urologist

Call 551-996-8090

 


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