CPT® Code 50783

An open ureteroneocystostomy is a surgical procedure that involves the reattachment of the ureter to the bladder, specifically designed to address issues at the ureterovesical junction (UVJ). In this procedure, the distal segment of the ureter is carefully divided at or near the UVJ, which is the point where the ureter connects to the bladder. Following this, an incision is made in the dome of the bladder wall, extending down to the mucosal layer. A smaller incision is then created in the bladder mucosa to facilitate the connection with the ureter. The detached ureter segment is meticulously trimmed and its end is spatulated, which means it is shaped to create a wider surface area for the anastomosis. This full-thickness connection is established between the ureter and the bladder mucosa, ensuring a secure attachment. To prevent the backflow of urine, the bladder wall is closed over a 2-3 cm segment of the ureter, forming a tunnel that aids in maintaining the proper position of the ureter. The original opening at the UVJ is subsequently closed to complete the procedure. In some cases, a temporary ureteral stent may be inserted to maintain the patency of the ureter and promote healing during the recovery phase. This procedure is particularly indicated when extensive ureteral tailoring or reconstruction is necessary before the ureter can be implanted into the bladder.