Scientific Editor: Editorial Board ISUD website
- What is Pyeloplasty?
- When is it performed?
- What sort of preparation is required?
- How is Pyeloplasty performed?
- What about after the procedure?
- What is the effect on patient’s quality of life?
Pyeoplasty is the surgical procedure to restore UPJ stenosis (i.e. obstruction of the ureteropelvic junction). It can be performed either as open or laparoscopic surgery.
Pyeloplasty is performed when the ureteropelvic junction is obstructed (UPJ stenosis), causing problems such as urinary tract infections (UTIs) or progressive renal damage.
Standardized preoperative preparation is carried out in hospital.
In case you are on anticoagulant therapy, you should inform your physician.
Pyeoloplasty can be open surgery (with skin incision), laparoscopic or robotic, and is performed under general anesthesia. When open surgery is performed, a skin incision is made in the renal region, so that the surgeon can have access to the ureteropelvic junction (UPJ). In the laparoscopic method, small skin incisions are made to allow for a small high-resolution camera to be inserted and transfer the image to the screen, as well as for multiple surgical instruments to pass through and be used by the surgeon and surgery group (usually 2 assistants). As for robotic-assisted surgery, this is based on laparoscopic surgery, with the only difference that all surgical instruments are connected to an apparatus giving the potential to the surgeon to operate while sitting in front of a screen using all instruments remote from the patient.
Depending on the type of stenosis, various techniques are applied to achieve plastic repair of the obstructed area. A catheter will be placed to the bladder and a drainage tube to the renal region. In order to facilitate healing, either a small tube will be placed passing from the kidney to the skin (nephrostomy) or, more often, a small tube passing from the kidney to the bladder through the ureter (urinary catheter).
The catheter and drainage tube are usually removed after 2-4 days and average hospital stay is between 5 and 7 days.
Upon discharge from hospital, you will be given specific instructions about:
- when it is safe to restart your anticoagulant therapy
- when you can resume to intense physical activity
- what sort of antibiotic regimen you should receive postoperatively
- when to remove the urinary catheter
It will take about 14 days for the surgical wound to fully heal and 4-6 weeks until you can fully resume to your normal life. When the laparoscopic or robotic method is applied, recovery time is much shorter.
When still having the urinary catheter, you may feel some bladder irritation while urinating,
If renal functionality had been problematic before, it is necessary to have the kidney reexamined.