Post-Ureterectomy Complications: Leg Weakness After Surgery

Postoperative Issues Following Ureterectomy

Hello! I have a unilateral left-sided duplex kidney issue, which has led to recurrent urinary tract infections and repeated kidney inflammation requiring hospitalization.
Following my doctor's advice, I underwent my first laparoscopic surgery.
During the procedure, it was found that the location was difficult to excise, so the laparoscopic approach only allowed for the removal of the middle ureter of the duplex kidney, while preserving the junction of the bladder and the lower urethra, as well as the most distal ureter extending from the duplex kidney.
This means that only the mid-portion of the ureter extending from the duplex kidney was excised.

However, within a year post-surgery, I began experiencing recurrent kidney inflammation again.
Therefore, last week, upon my doctor's recommendation, I underwent an open surgery (not laparoscopic) to completely remove the residual ureter.
The incision was made on the left lateral abdomen, approximately eight centimeters long.

After the surgery, regardless of whether I am lying down, sitting, standing, or walking, my left leg feels weak.
It is difficult to turn over, and my left leg struggles to cross over to the other side.
Additionally, I feel that the muscles on the inner side of my left leg are hard to engage.
Could this weakness in my left leg be due to the surgery on the left lateral abdomen, as the incision might affect the strength of the left leg? (Is it because lifting my left leg requires the use of the muscles in the lateral abdomen?) I am concerned that this might be a complication from the surgery, and I am unsure why I am experiencing weakness in my left leg.
(I had the surgery on May 9, and since then, the leg on the surgical side has been weak, but I do not have any numbness.)

Ms. Li, 50~59 year old female. Ask Date: 2023/05/14

Dr. Xu Wencang reply Urology

Please schedule a follow-up appointment for evaluation by the surgeon.

Reply Date: 2023/05/14

More Info

After undergoing a ureterectomy, it is not uncommon for patients to experience leg weakness, particularly on the side of the surgery. This can be attributed to several factors related to the surgical procedure and the recovery process.

Firstly, the surgical approach itself can impact muscle function and strength. In your case, the incision was made on the left side of your abdomen, which may have affected the muscles in that area, including the oblique and abdominal muscles that play a role in stabilizing and moving the legs. When these muscles are compromised due to surgery, it can lead to weakness in the corresponding leg. The abdominal muscles are crucial for core stability, and any disruption can affect your ability to lift or move your leg effectively.

Secondly, postoperative pain and discomfort can also contribute to weakness. If you are experiencing pain in the surgical area, it may lead you to subconsciously avoid using your left leg as much, which can result in muscle atrophy over time. This disuse can further exacerbate feelings of weakness and difficulty in movement.
Additionally, the recovery process from major abdominal surgery can involve a period of reduced mobility. Patients are often advised to limit their activity to allow for healing, which can lead to decreased muscle strength and endurance. If you have been less active post-surgery, this could also contribute to the weakness you are feeling in your left leg.

Another important consideration is the potential for nerve involvement during surgery. While it is less common, surgical procedures can sometimes lead to temporary nerve irritation or damage, which can manifest as weakness or difficulty in muscle control. However, since you mentioned that you do not have any numbness or tingling sensations, it may be less likely that nerve damage is the primary cause of your symptoms.

It is crucial to communicate your concerns with your healthcare provider. They may recommend physical therapy to help strengthen the muscles in your leg and improve your overall mobility. A physical therapist can provide targeted exercises that focus on rebuilding strength and stability in your left leg while also addressing any pain or discomfort you may be experiencing.

In summary, the weakness in your left leg following ureterectomy can be attributed to a combination of surgical impact on the abdominal muscles, postoperative pain, reduced activity levels, and possibly nerve involvement. It is essential to follow up with your healthcare provider to assess your condition further and to develop a rehabilitation plan that addresses your specific needs. Early intervention can significantly improve your recovery and help restore strength and function to your leg.

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