Pyeloplasty (Blockage Removal)
Restoring urine outflow from your kidney
Minimally Invasive Procedure Offers a Simplified Way to Treat Ureteropelvic Junction Obstruction
It’s not pleasant when the flow of urine from your kidneys are blocked. The blockage is known as a ureteropelvic junction (UPJ) obstruction, and it can be quite painful. It can also lead to problems including infection, kidney stones and loss of kidney function.
At Beth Israel Deaconess Medical Center (BIDMC), we provide a minimally invasive surgery for UPJ blockage. Robotic pyeloplasty offers the same cure rates as a traditional open surgery, but with many other benefits.
What is Pyeloplasty?
Pyeloplasty is the surgical removal of a UPJ obstruction. Typically, scarring that's present from birth or a blood vessel pressing on your ureter (the tube that carries urine from your kidney to your bladder) causes an UPJ blockage. Types of pyeloplasty include traditional open surgery and minimally invasive robotic pyeloplasty. Urology and kidney care specialists have expertise and experience in pyeloplasty care.
More About Pyeloplasty
Surgeons perform open pyeloplasty through an 8- to 12-inch incision. This incision extends from the back of your ribs across your flank to the bottom of your abdomen.
Robotic pyeloplasty uses three tiny "keyhole" incisions in your abdomen. Each incision is about 1 centimeter long. Surgeons insert a laparoscope (a thin tool with a lighted camera on its tip) and thin specialized instruments through these incisions. They locate the incision and either remove it or repair it using special suturing techniques. They also place a stent in your ureter to keep the ureter open. The stent stays in place for about three weeks. Your urologist removes it during an office visit.
Like an open procedure, robotic pyeloplasty takes place while you’re under anesthesia. But with robotic assistance, your surgeon can operate with extreme precision and minimal tissue disruption. There's a 95% success rate with robotic pyeloplasty, which is similar to open surgery. But when compared to open surgery, robotic pyeloplasty offers many benefits, including:
- A shorter hospital stay.
- Better cosmetic results.
- Less pain.
- Quicker recovery.
After surgery, you have a urinary catheter and an abdominal drain in the area near your kidney. We remove both within one to two days.
You will also have some discomfort. Our pain management specialists will provide you with a self-controlled pain pump you can use to deliver pain medicine as needed. It stays in place until the day after surgery, when we replace it with pain pills. They're available to you for several days after discharge. By then, over-the-counter acetaminophen or ibuprofen will usually control your discomfort.
You can resume normal eating on the first day after surgery or shortly after. Usually, you have a two-day hospital stay. The complete recovery time from surgery is three to four weeks.. For open pyeloplasty, the recovery time is eight weeks.
Follow-Up Care
You follow up with your surgeon one month after your operation. Then, you have follow-up appointments at three months, 12 months and 24 months. Nuclear renal (kidney) imaging and kidney ultrasounds may also take place. If you live outside of the Boston area, we can do non-imaging appointments over the phone.
