A few days after being treated for kidney stones, Elizabeth J. was back in the ER with severe pain. Imaging tests showed an obstruction in her kidney, and her doctor suggested removing it with a minimally invasive procedure that involved threading a scope into the kidney through her ureter, a tube that leads from the kidney into the bladder. But there was a problem: he couldn’t get the scope through.
That’s when Elizabeth learned that her ureter had been damaged by cancer treatment she had undergone many years prior.
After being diagnosed with cervical cancer 20 years ago, Elizabeth underwent surgery, chemotherapy, and radiation. The treatment was successful, and she moved on, apparently without side effects.
“I just adopted the attitude that I was grateful and kept moving forward,” she said. “I never felt any compromise or decline from my ureter.”
Kidney Discomfort
Looking back now, Elizabeth realizes that wasn’t entirely true. An avid athlete and fitness enthusiast, she had sometimes experienced discomfort in her kidney area but chalked it up to working out too hard, she says.
Now, her ureter was so closed up that it wasn’t draining at all. Her doctor put in a nephrostomy tube so that her right kidney could empty into a bag. He also referred her to Jay Simhan, MD, FACS, a urologist at the Fox Chase – Temple Urologic Institute who specializes in reconstructive urology and urologic prosthetics.
After more tests, Dr. Simhan gave her three options: do nothing and live with the tube, surgically rearrange her urinary system around the damaged ureter, or reconstruct a new ureter to replace the damaged one.
She Chose Reconstruction Surgery
“I liked that he didn’t have to move anything else around,” Elizabeth says. “He said, ‘The kidney stays where it is, the bladder stays where it is, but we’ll use a small segment of your bowel, and we’ll make that into a ureter and reattach things.’”
In a five-hour surgery, Dr. Simhan removed the damaged ureter, then removed a segment from her intestine and used it to make a new ureter.
A plastic surgeon participated to help close the incision, remove old scar tissue from Elizabeth’s abdominal cavity, and make things look as cosmetically normal as possible.
Elizabeth spent five days in the hospital and then went home. As an active person who loves running and circuit training, she finds the slow journey of recovery sometimes hard. “Walking to the top of my driveway and realizing I couldn’t go further was a recognition that my body had been through a lot,” she recalls.
Elizabeth applied her determination to her recovery and gradually worked up to walking two miles a day. After several months, she started going back to the gym to work on her strength.
Feeling Strong and Happy
“I’m not where I want to be yet, but I feel really strong, and I’m really happy to be where I am,” she says.
Recently, she had her first urinary tract infection, which is more common in people who’ve had their ureter reconstructed. After being treated, Elizabeth worked with Dr. Simhan to create a management plan, including changing out of sweaty gym clothes immediately after working out and seeking care right away if she experienced symptoms again to reduce the risk of infection.
“I feel good,” she says. “My body’s asking me to pay even more attention to it than I did before, and that’s not bad.”