Pyeloplasty

Pyeloplasty

Pyeloplasty is the standard treatment for ureteropelvic junction (UPJ) obstruction and involves surgical reconstruction of the blocked ureters; it accounts for a success rate of greater than 90 percent. In UPJ obstruction, the urine formed in the kidneys may not pass into the ureters. This builds up pressure inside the pelvis and kidney, which eventually causes a decline in the kidney function.

What is pyeloplasty?

Pyeloplasty is a surgical procedure which involves removal of a blockage in the ureter. The ureter is reconnected to the kidney along with a stent placed inside it to promote healing and drainage of the urine. Thus, pyeloplasty helps in restoring the structure and function of the kidney.

The following are the benefits of laparoscopic pyeloplasty:

Reduced hospital stay
• Less invasive
• Smaller incision and less pain
• Negligible scarring
• Most favorable results
• Early recovery

Who can undergo surgery?

Individuals having a blockage at the junction where the ureter and renal pelvis meet, need to undergo pyeloplasty surgery.
Individuals who manifest clinical symptoms such as difficulty in passing urine, flank pain, and recurrent urinary infections are the right candidates for undergoing pyeloplasty.

What are the types of laparoscopic pyeloplasty?

The different types of laparoscopic repairs are:

• Anderson-Hynes dismembered pyeloplasty
• Foley Y-V plasty
• Fengerplasty

Before pyeloplasty

Before pyeloplasty, the doctor instructs the patient to undergo required medical examinations to ensure if the patient’s health condition is suitable for undergoing the procedure.

The following measures are to be taken before undergoing pyeloplasty surgery:

• Stop using aspirin, NSAID’s and blood thinning medications.
• Avoid using herbal medications or supplements before the surgery.
• Stop smoking to stay away from negative consequences.
• Ensure extra care and proper diet before the surgery.

During the procedure

During the laparoscopic pyeloplasty, the surgeon administers general anesthesia and makes several small incisions in the abdomen. An endoscope and specialized instruments are allowed to pass through the incisions into the abdomen, to help the surgeon access the operative area while performing the surgery. The surgeon dissects and exposes the kidney to remove the blockage in the ureter and renal pelvis.

A stent is placed inside the ureter to promote healing and drainage of the urine. The stent is later removed after four weeks.

After the procedure

The patient may experience mild pain, nausea, and fatigue after the procedure. Pain medications are administered to counteract the postoperative pain. The clinical staff continuously monitors the condition of the patient and provides the necessary care for early recovery. Intravenous fluids are administered to the patient until the digestive tract gets stabilized to consume solid food.

The patient may feel flank fullness due to the presence of a stent in the abdomen; the stents are usually removed after a month. However, the symptoms will improve gradually. After the discharge, the patient must ensure proper home care and follow-up with the doctor regularly.

Complications after pyeloplasty

Following are the complications associated with pyeloplasty:

• Bleeding
• Internal injury
• Herniation
• Infection
• Failing to correct the UPJ

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