scar tissue forming after ureter surgery, after removal of stent

[matdt]

My brother underwent the removal of a tumor from his left ureter. He was born with only one kidney and one ureter 49 years ago and has enjoyed perfect health. He has been a vegetarian for over 30 years and has truly taken good care of himself, neither ever having smoked nor overindulging with alchohol. About 2 months ago, at Flagstaff Medical Cenetr in Arizona, the tumor was removed intact as was his ureter, with the urilogic surgeon and his partner performing a ureter reconstruction. They cut a flap from the bladder a formed a tube to act as the ureter. There was quite a bit of stitching required to construct this tube and reclose the bladder itself. A stent was inserted for a duration of 6 weeks. A this point, a nephrostomy tube and a urinary catheter were also removed. My brother recuperated in a timely fashion, went back to work, drove, ran his errands, etc.  However, last week, he commenced feeling unwell, feverish, with a loss of appetite. His urologist took some tests which showed blood impurities. Indeed urine had backed up because of major scarring within his one reconstructed ureter. He has just been re-operated on with scar tissue being removed and a new stent being inserted with a time frame of 3-4 months of retention. He'll be going home tomorrow with the nephrostomy tube and the urinary catheter again. This is truly demoralizing to him. Is any of this to be expected, did his surgeon remove the stent too early, should he get another opinion, will scarring continue???
He was just starting to go forward in his life, and now he's been subjected to this other surgery which has set him back severely. Is he being told every thing he needs to know about stents and scarring or are there more specific questions we his family should ask?? Can you shed light on this situation for us??

[Kevin Pho, MD]

Hello - thanks for asking your question.

From your description, I do not see any overt mistakes.

Leaving the stent in for 6 weeks is a typical duration.  One of the unfortunate complications, especially after ureteral recontruction, is scarring.  It is impossible to predict the occurance and position of scarring and I am sure that your urologists are doing what they can to prevent this occurance.  

To find a second urological opinion, here is the website from the American Urological Association. You can find a urologist near you for a second opinion:
http://www.urologyhealth.org/find_urologist/


Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Thanks,
Kevin, M.D.

[Angelia]

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[MB823]

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