One of the main jobs of the kidney is to filter the blood, and deliver the waste products (urine) to the bladder. The urine leaves the kidney, enters the renal pelvis, and then passes into the ureter through a funnel called the ureteropelvic junction (UPJ). In some children there can be a partial blockage at the UPJ. The blockage may be severe (high grade), minimal (low grade) or intermittent.
Ultrasonography and intravenous urography (IVU) will show hydronephrosis (enlargement of the kidney) related to the UPJ obstruction. Other studies, such as a diuretic renal scan (DRS) may be needed to evaluate the function of the kidneys.
The usual repair of a UPJ obstruction (pyeloplasty) involves removing the blockage, and reconnecting the ureter to the renal pelvis. Depending on the individual circumstances a tube may be left across the pyeloplasty (stent) or a tube may be left above the repair to decompress the kidney (nephrostomy).
Pyeloplasty is a surgical procedure to relieve swelling of the kidney (hydronephrosis) that is caused by a blockage between the kidney and bladder (ureteropelvic junction obstruction). This blockage obstructs the flow of urine from the kidney to the bladder, causing the kidney to swell with excess urine. Pyeloplasty is the most common treatment for infants and children.
This surgery can be done in three different ways: open technique, laparoscopic, or laparoscopic with robotic assistance. Your surgeon will discuss each option with you and recommend the method that is best for your child and their individual situation.
Most children spend 1 to 2 nights in the hospital following pyeloplasty.
It is normal to see some blood or small blood clots in the urine, when voiding, if your child has a stent in place. This can happen during the first few weeks after surgery. Stents can also cause some children to feel discomfort when urinating, especially on their backside, where the procedure was performed.
Please make sure your child does not engage in strenuous or high-intensity activities until the follow-up renal ultrasound.
Your child may have one of the following that will remain in place after surgery and during the recovery period, and will be removed during a follow-up procedure.
This type of stent will be removed during an outpatient procedure in the operating room. Your child will go home the same day.
This type of stent/tube can be removed in the urologist's office during a follow-up appointment.
We will need to monitor the output of the JP drain. During your post-operative recovery, we will call and ask how much draining your child is experiencing. Once the output is minimal, the drain will be removed in the urologist's office.
Usually, there are 2 follow-up appointments:
You should call the doctor if your child experiences any of the following:
UT Pediatric Urology
UT Physicians Professional Building
6410 Fannin St. Suite 950
Houston, Texas 77030
Phone: (832) 325-7234
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