Hyderabad: Docs at Preeti Urology and Kidney Hospital perform India’s first bilateral ureteral reconstruction

Hyderabad: A 52-year-old woman suffering from severe ureteral damage that threatened to permanently impair her kidney function has undergone a rare and complex laparoscopic surgery at Preeti Urology and Kidney Hospital.

The marathon 9.5-hour operation, led by Dr. V. Chandramohan, successfully replaced both ureters using segments of the patient’s small intestine — a first-of-its-kind procedure in India.

The woman’s condition stemmed from complications following a hysterectomy performed three years ago. Due to infection or other post-surgical factors, both ureters — the tubes connecting the kidneys to the bladder — had completely deteriorated over time, leading to repeated urinary infections and a significant rise in creatinine levels, a marker of kidney distress.

Complete Ureteral Damage Discovered

On evaluation at Preeti Urology, it was found that the patient’s ureters were damaged along a 35 cm stretch, with only the renal pelvis remaining intact. Temporary stents had previously been used, but her condition continued to decline.

“This is an extremely rare scenario. Globally, only nine such cases have been treated, and never before in India,” said Dr. V. Chandramohan, Managing Director and Consultant Urologist at the hospital, during a press conference at Taj Deccan Hotel. “We were dealing with complete bilateral ureteral damage. Without reconstruction, the patient risked total kidney failure.”

Complex Laparoscopic Surgery with 13 Incisions

To address the condition, Dr. Chandramohan’s team performed a full ureteral reconstruction using a minimally invasive laparoscopic approach. Unlike standard procedures, which typically require three small incisions, this surgery needed 13 keyhole incisions for better access and precision.

“We had to take two 35 cm sections from the patient’s small intestine, reshape them to function as ureters, and connect them from each kidney to the bladder,” explained Dr. Chandramohan. “Because the ureters were entirely non-functional, this was the only way to restore urinary flow.”

First in India, Among Few Globally

According to Dr. Chandramohan, this is the first time in India that such a bilateral ureteral reconstruction has been done entirely through laparoscopic (keyhole) surgery. “Similar cases have only been handled in China, where nine patients underwent comparable procedures, but with a shorter average surgery time,” he said. “In India, this condition has been treated before, but always through open surgery.”

Recovery and Outlook

Post-surgery, the patient’s kidney function has stabilized, her creatinine levels have returned to normal, and she is now walking independently. The success of the operation highlights the potential of advanced laparoscopic techniques in managing even the rarest of urological conditions.

“Such surgeries require not only state-of-the-art technology but also specialized surgical expertise,” Dr. Chandramohan added. “At Preeti Urology, we’re equipped for such challenges, and this case demonstrates the kind of outcomes that are possible.”

The hospital’s team hopes this milestone will pave the way for more minimally invasive solutions to complex urological problems in India.