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Partial ureterectomy
A partial ureterectomy removes only the diseased segment of your ureter — the tube that carries urine from kidney to bladder — then reconnects the healthy ends, sparing the rest of the kidney and ureter. It's a kidney-sparing operation most often used for a tumor confined to one part of the ureter, a stubborn stricture, or ureteral endometriosis, and it's usually performed by a urologist.
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Briefly about this treatment
Indications
A ureteral tumor confined to one segment of the ureter (most often low-risk upper tract urothelial carcinoma), a severe stricture or blockage that hasn't responded to less invasive options, or ureteral endometriosis obstructing urine flow.
Risks
Bleeding, infection, urine leakage at the reconnection site, and stricture developing later at the repair site. Risks are minimised by careful patient selection and an experienced surgical team.
Pre-procedure
CT urogram and other imaging, ureteroscopy with biopsy, cystoscopy to check the bladder, blood tests including creatinine and eGFR, an anaesthesia consultation, and fasting per protocol. Some blood thinners may need to be paused beforehand.
Follow-up
Stent removal by outpatient cystoscopy at 4–6 weeks, scheduled surveillance imaging and cystoscopy (more frequent in the first year for cancer cases), and long-term monitoring of kidney function (creatinine, eGFR).
What is Partial ureterectomy? An expert explains
The ureter carries urine along its whole length, so disease anywhere in it can, in theory, mean removing the whole kidney and ureter (a radical nephroureterectomy). But when disease is limited to one segment, urologic surgeons increasingly prefer „kidney-sparing surgery” — and partial ureterectomy is one of its main forms, alongside endoscopic (ureteroscopic) tumor removal. European Association of Urology (EAU) guidelines recommend offering kidney-sparing management as the primary option to patients with low-risk upper tract urothelial carcinoma (UTUC — cancer of the lining of the ureter or kidney drainage system), and recommend discussing distal ureterectomy specifically for low-risk tumors in the lower ureter. Comparative studies have found similar cancer-control outcomes between segmental ureterectomy and full removal of the kidney and ureter in carefully selected patients, with the added benefit of preserved kidney function.
Partial ureterectomy isn’t only a cancer operation. Surgeons also use it for severe, treatment-resistant ureteral strictures and for ureteral endometriosis — a form of endometriosis that grows around or into the ureter and blocks urine flow — when less invasive options haven’t worked.
Signs it may be time for Partial ureterectomy
You can’t diagnose a ureteral problem from symptoms alone, but a few things tend to prompt the tests that lead here:
- Visible or microscopic blood in your urine (hematuria) that imaging traces to a localized spot on the ureter
- Flank or side pain, dull or sharp, sometimes on only one side
- A section of ureter that’s narrowed or blocked, with swelling in the kidney (hydronephrosis) as a result
- Recurring urinary tract infections on the same side
- Reduced urine output or a noticeable change in your urine stream
These entries are not a diagnosis or a treatment recommendation. Your clinician decides whether a partial ureterectomy is appropriate using your symptoms, examination and test results. In KidneyGlobal’s directory, this treatment is linked to the following conditions:
- Obstructive Nephropathy — Blocked urine flow damages the kidneys.
- Hydronephrosis — Swelling of the kidney from urine buildup behind a blockage.
- Tumor Obstructive Nephropathy — A tumor compresses or grows into the ureter, impeding urine flow.
- Bladder Cancer (Upper Tract Obstruction) — A malignant blockage of the urinary tract’s outflow.
- Ureteropelvic Junction Obstruction — A blockage where the kidney’s drainage system meets the ureter.
Remember: These entries are not a diagnosis or a treatment recommendation. Discuss your symptoms and test results with a qualified clinician.
When to consult a specialist
Blood in your urine, ongoing flank pain, or a urinary infection that keeps coming back are worth getting checked — most causes are manageable, and the sooner they’re found, the more options you usually have. A simple blood and urine test, plus some imaging, is often enough to see what’s going on and whether a partial ureterectomy is even relevant to your situation. If you’ve already been told you have a ureteral tumor, mass, or stricture, it’s a good time to get a specialist’s view on next steps. You can consult a specialist directly through KidneyGlobal using the find a specialist link.
How a session works
You’ll receive general anesthesia, so you’re asleep for the whole operation, and a catheter is placed in your bladder to drain urine during and after surgery. Your surgeon then operates through one of two approaches:
- Laparoscopy (including robotic-assisted). Several small incisions instead of one large one; a camera and slim instruments do the work, often with robotic assistance for extra precision and a 3-D view. This is now the more common approach for distal (lower) ureteral disease.
- Open surgery. One larger incision in the side or abdomen. Your surgeon may start laparoscopically and switch to open surgery if needed for safety.
In one published robotic case series, the operation itself took about 100 minutes of console time with roughly 50 ml of blood loss.
Session duration
2–3 hours
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$15000–$30000
indicative range
Anesthesia
General
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Remember: The exact steps, duration and preparation can vary with your indication, health and care setting. Confirm the current plan with your treating team.
Benefits
The main appeal of this surgery is what it doesn’t take away: your whole kidney.
- Keeps your kidney. Unlike a radical nephroureterectomy, which removes the whole kidney and ureter, this surgery preserves kidney tissue, and in several studies kidney function (eGFR) actually improved afterward compared with full removal.
- Comparable cancer control in selected patients. For appropriately selected low-risk, and some high-risk, ureteral tumors, studies have found similar recurrence-free, cancer-specific, and overall survival compared with full kidney-and-ureter removal.
- Lower morbidity than radical surgery. EAU guidelines note kidney-sparing surgery reduces the illness burden associated with radical treatment without giving up cancer control in low-risk disease.
- Minimally invasive options. A laparoscopic or robotic-assisted approach can mean less blood loss, smaller scars, and a technically precise repair, even for patients with other health conditions.
Risks & side effects
A partial ureterectomy has risks and trade-offs to discuss with your care team. The information below comes from this treatment’s data: bleeding, infection, and issues at the site where the ureter is reconnected are the main concerns, and they’re minimised by careful patient selection and an experienced surgical team.
- Bleeding, which occasionally needs a blood transfusion
- Infection
- Urine leakage from the ureter or bladder while the reconnection heals
- Stricture (narrowing) developing later at the reattachment site
- Damage to nearby organs such as the bowel, blood vessels, or bladder
- Blood clots (deep vein thrombosis or pulmonary embolism)
- General anesthesia risks, which your anesthesia team will review with you
- Stent-related discomfort while it’s in place: urinary urgency, frequency, a burning feeling, or blood-tinged urine — this is expected and settles once the stent is removed
Who it may not suit. These are general cautions, not a personal verdict: widespread disease along the ureter or kidney drainage system, very limited remaining kidney function on that side, or a tumor too extensive for a segmental approach may point toward a different treatment instead. A qualified clinician must assess your full medical picture before recommending or delaying treatment.
What happens during & after
During surgery, your surgeon first checks for any spread of disease. The affected segment of ureter (and, for cancer, nearby lymph nodes) is removed. The two healthy ends are then either:
- stitched back together directly (ureteroureterostomy), or
- the remaining ureter is reattached to the bladder (ureteroneocystostomy) — if the gap is longer, the bladder itself may be stretched up to meet it using a psoas hitch or a bladder flap technique called a Boari flap.
A temporary internal stent is placed to hold the ureter open and support healing, running from the kidney to the bladder; it typically stays in for 4–6 weeks. The bladder catheter may stay in a little longer while the reconnection heals, and one or more small drains may be left near the incision.
Right after surgery, you’re monitored in a recovery unit as the anesthesia wears off — some grogginess, nausea, or a sore throat (if a breathing tube was used) is normal. Once stable, you’re moved to a hospital room, where pain is managed with medication and your care team checks your catheter, drains, and urine output.
The surgery itself takes about 2–3 hours, and most people stay in hospital for roughly 1–3 nights, though this varies with the approach used and how complex the repair is — some published case series report average stays closer to a week.
Possible complications
Beyond the common risks above, a smaller number of people face a complication further down the line.
- Local or „ipsilateral” recurrence. Because the urothelium (the lining that can develop these tumors) runs throughout the urinary tract, cancer can recur elsewhere in the same kidney or ureter, which is why ongoing surveillance matters. In one study of 450 patients, this happened in about 16% of cases, and roughly 1 in 10 patients eventually needed a full kidney-and-ureter removal afterward.
- Surgical complications. A 2023 series of segmental ureterectomy for high-risk ureteral cancer reported complications (mostly minor, Clavien-Dindo grade I–II) in 15% of patients.
- Recurrent obstruction. For benign disease such as ureteral endometriosis, the stricture or blockage can recur at the repair site, occasionally requiring a second surgery.
- Tumor seeding, a rare risk where cancer cells spread into new areas during surgery.
Your surgical team will weigh these risks against your specific diagnosis, kidney function, and overall health — this page is general education, not a substitute for that conversation. The complication rates above come from the cited studies, not KidneyGlobal’s own data, and should be verified against current literature before publishing.
Remember:
New or severe symptoms require prompt medical advice. Do not wait for a routine appointment if you feel seriously unwell.
Recovery
In the hospital. Most people stay roughly 1–3 nights, longer for more complex repairs. Your catheter and any drains are usually removed before you go home; if not, your team will show you how to care for them. Pain is managed with medication throughout your stay.
At home. Have someone stay with you for the first few days. While you recover:
- Take all medicines exactly as directed
- Care for your incisions and any catheter or drains as you were shown
- Hold off on full showering, bathing, swimming, or hot tubs over the incision until your provider clears it
- Avoid strenuous activity and heavy lifting until your provider says it’s okay — usually several weeks
- Don’t drive until cleared, and not at all while taking drowsy-making pain medicine
- Avoid straining with bowel movements; ask about a stool softener if needed
While your internal stent is in place, expect to urinate more often, with some burning or blood-tinged urine — this is normal and resolves once it’s removed.
Follow-up. Stitches or staples, if used, typically come out 7–14 days after surgery. The internal stent is removed via a quick outpatient cystoscopy at about 4–6 weeks. For cancer surgery, expect a structured surveillance schedule — cystoscopy, urine cytology, and imaging — often more frequent in the first year, since recurrence risk is highest early on. Regular kidney function checks (creatinine, eGFR) continue over the longer term, especially important if you have a single or reduced-function kidney.
Call your doctor right away if you notice:
- A fever of 100.4°F (38°C) or higher
- Heavy bleeding or drainage from an incision, or large blood clots in your urine
- Signs of infection: redness, swelling, warmth, worsening pain, or bad-smelling drainage at an incision
- Leg pain or swelling
- Inability to urinate, or pain that isn’t controlled by your medicine
- Vomiting that won’t stop
Call emergency services for chest pain or trouble breathing.
Recovery timelines vary by person and by how the surgery was done — your own surgeon’s guidance always takes priority over general ranges like these.
Clinics offering Partial ureterectomy
Verified kidney centres linked to this treatment in the KidneyGlobal directory.
University Hospital
Urologic Oncology & Robotic Surgery
ISO 9001European Urology Boardda Vinci Robotic Center
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Academic Medical Center
Minimally Invasive Urologic Surgery
Joint CommissionNCI Cancer CenterRobotic Surgery Excellence
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Academic Medical Center
Kidney Transplantation
Joint CommissionUNOS CertifiedLiving Donor Excellence
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Good questions
Most Common Questions
How is a partial ureterectomy different from a radical nephroureterectomy?
A radical nephroureterectomy removes the entire kidney and ureter. A partial ureterectomy removes only the diseased segment and keeps the kidney and the rest of the ureter in place, which is why it's called "kidney-sparing."
Will I need dialysis afterward?
Most people don't. Preserving kidney tissue is the whole point of this surgery, and studies have shown kidney function (eGFR) can actually improve after segmental ureterectomy compared with full kidney-and-ureter removal.
Is this only done for cancer?
No. It's also used for severe ureteral strictures and ureteral endometriosis that haven't responded to less invasive treatment.
Will I need ongoing monitoring afterward?
Yes, especially after cancer surgery. Because the lining that produces urothelial tumors runs throughout the urinary tract, you'll have regular follow-up imaging and cystoscopy to check for recurrence.
How long is the hospital stay?
Most people stay about 1–3 nights, though this can run longer for more complex reconstructions or if complications arise.
Can my kidney specialist (nephrologist) perform this surgery?
No — a nephrologist manages kidney function and disease but doesn't perform ureteral surgery. This procedure is done by a urologist, and your nephrologist and urologist typically coordinate care, especially if you have reduced kidney function.
Sources
- Guideline on Upper Urinary Tract Urothelial Carcinoma (2025)European Association of Urology (EAU)
- Distal Ureterectomy patient guideOU Health / StayWell
- Oncological and renal outcomes of segmental ureterectomy vs. radical nephroureterectomy (Kato et al., Oncology Letters, 2018)PMC (National Library of Medicine)
- Segmental ureterectomy for high-risk ureteral carcinoma: a preliminary report (Wei et al., BMC Urology, 2023)PMC (National Library of Medicine)
- Kidney-Sparing Surgery for Upper Tract Urothelial Carcinoma — Modalities, Outcomes, and Limitations (Head & Raman, Journal of Clinical Medicine, 2024)PMC (National Library of Medicine)
- Case report: segmental ureter excision for ureteral endometriosisPMC (National Library of Medicine)