Overview of Pyeloplasty

Pyeloplasty is a surgery that is used to correct ureteropelvic junction obstruction. Ureteropelvic junction obstruction is a condition that blocks the flow of urine from the kidney into the ureter. This can be diagnosed through a variety of imaging tests. During the pyeloplasty, your physician will make a small incision in the abdomen. Then the obstructed segment will be removed and a new tube will be put in its place. Recovery time is very quick. It is better to do this procedure as early in life as possible. Once the problem has been fixed, then it is not likely to come back. There are no real risks that are associated with this procedure. Below you will see the risks and side effects that you may experience. If you experience any of these, it is important that you call our office immediately.

What is Ureteropelvic Junction Obstruction?

Ureteropelvic junction obstruction is a condition that blocks the flow of urine from the kidney into the ureter. The blockage is typically found where the renal pelvis attaches to the ureter. This condition is most common in children, and is most commonly occurs right at birth. When this condition occurs right at birth, it is called a congenital condition. The blockage occurs between the ureter and the kidney. It occurs right when the kidney begins to form. This typically results in a damaged kidney from the urine buildup and an increase in pressure in the kidney. It typically only occurs in one kidney.

It can occur in adults and children if they have kidney stones, infections, scar tissue, an abnormal blood vessel, or have had earlier treatments for blockages.

Diagnosis of Ureteropelvic Junction Obstruction

Ureteropelvic junction obstruction is found in an ultrasound before the child is born, but in some cases will not show until after the child has been born. It is typically not hereditary, but can rarely be seen in multiple family members.

After the child has been born, multiple tests can be performed. These tests include:

  • Blood test
  • CT scan
  • CT urogram
  • Urine test
  • Ultrasound
  • Electrolytes
  • X-ray of bladder
  • Nuclear scan of kidneys

Symptoms of Ureteropelvic Junction Obstruction

Kidneys can become very damaged as a result of ureteropelvic junction obstruction with urine build up. Symptoms may include:

  • Vomiting
  • Urinary tract infection
  • Abdominal mass
  • Bloody urine
  • Poor growth in infants
  • Back pain

How is Ureteropelvic Junction Obstruction Treated?

Ureteropelvic junction obstruction is typically treated with pyeloplasty. This procedure needs to be done as early in life as possible. In some cases, the procedure can wait until later in life. After this procedure is done, the urine will be able to flow normally. In children, the surgery will be open. In adults, the procedure will typically be less invasive. The whole procedure usually takes a couple of hours. During the pyeloplasty, a two-inch incision will be made right under the ribs. You may be given a bladder catheter during your procedure to drain the bladder. After this incision is made, the obstructed segment of the ureter is then removed. Then a normal caliber ureter then will be put into the place. A stent will be placed to aid in draining the urine from the kidney. After you are completely healed after surgery, then you will have the stent removed.

While you are in the hospital, you will be given medication for pain. In some cases, you will have been given an epidural nerve block so that there is no pain between the surgery and waking up from surgery.

If you have ureteropelvic junction obstruction, then you will want to speak to your physician. Make a list of all of the symptoms that you are experiencing. At your appointment with your physician, then you can let them know what you are experiencing and you can go over the advantages and disadvantages of the procedure.

Recovering from a Pyeloplasty

After surgery, it is most likely that you will stay in the hospital for a day or two. Recovery is typically very fast. You may have some pain after surgery and your ureter may also be swollen. The kidney drainage may not be the best right after surgery, but it will get better as you heal. At a follow up appointment, then your stent will be removed. Your physician may also want to do an ultrasound to check to see if the kidneys are still swollen. You may be given a bladder catheter during the surgery, so you may feel pain and feel the need to urinate frequently.

This procedure is the best option if you have ureteropelvic junction obstruction. The results are very successful, and you may experience light scarring in the abdomen area. Once the Ureteropelvic junction obstruction has been corrected, it is most likely not going to come back. However, surgery will put you at risk for kidney stones and infections.

Risks of Pyeloplasty

This procedure is typically a very safe procedure. If you believe that you have an infection from this surgery, it is important to call your physician immediately. If you are experiencing any of the following symptoms, then you will want to call our office. The symptoms include:

  • Temperature over 101 degrees
  • Vomiting and nausea
  • Symptoms that you were experiencing before surgery that return
  • Difficulty urinating
  • Unusual irritability
  • Excessive bleeding

You may also experience side effects from the medication that you were given. If you are experiencing side effects from the medication, then it is best to end the medication immediately and call our office. Our physicians may be able to offer alternate forms of medications that will work better for you.

Summary of a Pyeloplasty

A pyeloplasty is a procedure that is done to correct a ureteropelvic junction obstruction. This procedure is very low risk. Once this has been done, you will likely not experience this problem again. If you are considering this procedure, then you should call our office to schedule a consultation. Our physicians can discuss the advantages and disadvantages of this procedure with you.

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To request an appointment with Urology, call 251-343-9090. To request an appointment with Radiation Oncology, call 251-414-5665.

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