Complex Urological Re-Constructive Surgery Brings Relief to a 6-year-old

Getting to know that a child’s lack of appetite, poor growth & an enlarged belly is linked to a birth defect of the urinary system can be naturally startling for parents. Parents of 6-year-old Shikha (name changed), were in a shock when she was diagnosed with a rare birth defect is known as Mega-ureter which was also gradually affecting her kidney. They turned to the super specialists at Narayana Multispeciality Hospital, Jaipur for treatment.

The urine travels from the kidneys to the bladder in thin tubes called ureters, which are normally 2mm to 3mmwide in adolescents. In the patient’s case, who was only 6 years old, the left-sided ureter was dilated (enlarged) & tortuous (twisted) with an unusually large size – 8 cm wide. The Meg-aureter was covering over 60 percent of the abdominal cavity, putting pressure on the stomach, resulting in a lack of appetite, poor growth and an enlarged belly. Also, the birth defect had resulted in a shift of the organs, namely the stomach and intestine from left to right side of the abdomen.

Her parents brought her to Narayana Multispeciality Hospital, Jaipur where she underwent a CT Scan & other tests to correctly diagnose the condition. “The patient came to us with complaints of recurrent urinary tract infections, fever and an enlarged belly. She was also very weak & underweight. Diagnostic tests revealed that she had a mega-ureter on the left side. Unlike, a normal child, the left ureter was enlarged with weak muscle walls resulting in pooling of urine inside the ureter. This was the cause behind repeated infections & fever. In such a case, it was evident that only surgical intervention could ease the patient’s suffering” said Dr.Madhusudan Patodia, Consultant – Urology & Renal Transplant at NarayanaMultispeciality Hospital, Jaipur.

Pushing the boundaries of clinical care, an expert team comprising of Dr. Amit Kotia and Dr. MadhusudanPatodia operated upon the patient. “The surgery was technically demanding as the entire left ureter which covered over 60% of the abdomen was to be surgically removed, with utmost precision, without affecting the nearby organs. A new ureter also had to be re-construed out of healthy tissues from the body, which would naturally grow with age. We took up the challenge & were successful. A new ureter was re-constructed from portions of the bladder. A flap-like portion of the bladder was prepared, re-constructed into a new ureter & surgically implanted up to left renal pelvis” said Dr. Amit Kotia, Sr.Consultant – Urology & Renal Transplant. 

The patient was discharged within 72 hours of surgery & is now on regular follow up visit. Her appetite has increased & the pot belly has also disappeared. She is now back to her chirpy self & has resumed school within two weeks of the surgery.

“Kidney functioning can get impaired as a result of repeated infections caused by a megaureter. Any reconstruction of a body part, especially of a small child, is very complex and we are happy that our team could perform a complicated surgery such as reconstruction of the ureter and help the child recover to lead a normal life without any complications” said Dr. MalaAirun, Zonal Clinical Director, Narayana Multispeciality Hospital, Jaipur.

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