What is a pyeloplasty?
A pyeloplasty is a surgical treatment to relieve a urinary condition called ureteropelvic junction (UPJ) obstruction. An UPJ obstruction typically occurs in fetal development. When it occurs, it blocks the flow of urine out of the kidney into the ureter.
Although many cases are treated early in life, most surgeries can wait until later in life. During the surgery, a doctor will reconstruct the renal pelvis to drain and decompress the kidney. If left untreated, an UPJ obstruction can cause abdominal pain, kidney stones, infection, high blood pressure and deterioration of kidney function.
Who is a candidate for a pyeloplasty?
Most children who have UPJ are treated with open surgery, while adults are better candidates for a pyeloplasty.
Risks of a pyeloplasty
Although a pyeloplasty is a generally safe procedure, complications can occur. Complications may include:
- Bleeding at the operation site
- Injuries to surrounding organs
- Infection
- Nephrectomy may be necessary (removal of a kidney)
If the procedure is performed laparoscopically or with a robot, the rate of complications decreases significantly.
What to expect during a pyeloplasty
A pyeloplasty procedure can take a few hours. During the process, a 2-3-inch incision is made below the ribs, and the obstructed segment of the ureter is removed. The ureter is then reattached to the renal pelvis. Your doctor will place a stent to drain urine from the kidney. The stent will stay in place until your body heals from the surgery.
Some patients may be candidates for robotic-assisted or laparoscopic pyeloplasty. The same internal technique is followed, but the repair is done through multiple small holes instead of through a larger incision.
Recovery from a pyeloplasty
Recovery from a pyeloplasty is generally a quick process. Most patients need a one- to two-day hospital stay after a pyeloplasty procedure. For a few days after the procedure, you may experience:
- Swollen ureter
- Discomfort or pain at the affected site
- Poor kidney drainage
Results from a pyeloplasty
Most patients who undergo a pyeloplasty will experience long-term relief — typically the obstruction does not come back. Patients may be at risk for future kidney stones or kidney infections.