Pyeloplasty
all information

Pyeloplasty

Pronounced: PYE-ah-loh-plas-tee

En Español (Spanish Version)

Definition

Pyeloplasty is a surgery to repair the kidney. In this surgery, the renal pelvis and its connection to the ureter are repaired. The renal pelvis is a funnel-like structure in the kidney. It connects the kidney to the ureter. The ureter is a tube that carries urine to the bladder.

Kidney and Ureter

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Reasons for Procedure

Pyeloplasty is done if a blockage is found at the kidney's connection to the ureter. This blockage causes the kidney to balloon. The problem is often detected by ultrasound or CT scan .

Possible Complications

Complications are rare, but no procedure is completely free of risk. If you are planning to have a pyeloplasty, your doctor will review a list of possible complications which may include:

  • Bleeding
  • Infection
  • Hernia
  • Damage to tissues or organs
  • Persistent leakage of urine
  • Blockage of the ureter

Factors that may increase the risk of complications include:

What to Expect

Prior to Procedure

Tests will need to be done before surgery and may include:

  • Urinalysis
  • Physical exam
  • Blood tests

The bowels will need to be cleaned. To do this, your diet will be limited to clear liquids the night before. Do not eat or drink on the morning of the surgery.

Talk to your doctor about your medicines. You may be asked to stop taking some medicines up to one week before the procedure, like:

  • Aspirin or other anti-inflammatory drugs
  • Blood thinners, such as clopidogrel (Plavix) or warfarin (Coumadin)

Anesthesia

General anesthesia will be given. You will be asleep.

Description of Procedure

Pyeloplasty may be conducted by open surgery or laparoscopic surgery .

During open surgery, an incision will be made in your side. The doctor will reconstruct the renal pelvis to remove the blockage. The blocked section of the ureter will be removed. The remaining healthy sections of the ureter will be re-attached. The incision in the skin will then be closed with stitches.

In the laparoscopic version, the doctor will use special tools and tiny incisions. The other steps are the same as the open procedure.

In some surgeries, a temporary tube (stent) may be placed in the ureter to help urine pass.

How Long Will It Take?

About 2-3 hours

How Much Will It Hurt?

Anesthesia will block pain during the surgery. Minor pain following surgery is treated with medicine.

Average Hospital Stay

The usual length of stay is 2-3 days. Your doctor may choose to keep you longer if complications arise.

Post-procedure Care

At the Hospital

You will receive pain medicine to ease discomfort after surgery. You may also have some discomfort while urinating for the first few times following surgery. It is common to feel a frequent need to urinate.

At Home

  • If you are sent home with a drain or catheter, it may be removed one week after surgery. If no catheter was used, a follow-up appointment should be scheduled for 4-6 weeks after surgery.
  • Ask your doctor about when it is safe to shower, bathe, or soak in water.
  • If you are given antibiotics, you need to take the full course. Do not stop early. Be sure to follow your doctor’s instructions .

Call Your Doctor

After you leave the hospital, contact your doctor if any of the following occurs:

  • Signs of infection, including fever and chills
  • Redness, swelling, increasing pain, excessive bleeding or any discharge from the incision site
  • Nausea and/or vomiting that you cannot control with the medicines you were given after surgery, or which persist for more than two days after discharge from the hospital
  • Pain that you cannot control with the medicines you have been given
  • Pain, burning, urgency or frequency of urination, or persistent bleeding in the urine
  • Difficulty urinating
  • Any symptoms like those you had before surgery

In case of an emergency, CALL 911 .

RESOURCES:

American Urological Association
http://www.auanet.org/

Urology Health.org
http://www.auafoundation.org/

CANADIAN RESOURCES:

Canadian Urological Association
http://www.cua.org/

Health Canada
http://www.hc-sc.gc.ca/index-eng.php

References:

Inagaki T, Rha KH, Ong AM, Kavoussi LR, Jarrett TW. Laparoscopic pyeloplasty: current status. BJU Int . 2005;95(Suppl 2):102-105.

McAleer IM, Kaplan GW. Renal function before and after pyeloplasty: does it improve? J Urol . 1999;162(3 Pt 2):1041-1044.

Wash PC, Vaughan ED, Wein AJ, Kavoussi LR, Novick A, Partin AW. Campbell’s Urology . 8th ed. Philadelphia, PA: Saunders; 2002.

6/3/2011 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance: Mills E, Eyawo O, Lockhart I, Kelly S, Wu P, Ebbert JO. Smoking cessation reduces postoperative complications: a systematic review and meta-analysis. Am J Med. 2011;124(2):144-154.e8.



Last reviewed December 2010 by Adrienne Carmack, MD


Last updated Updated: 6/3/2011

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.

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