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Pyeloplasty

Pronounced: PYE-ah-loh-plas-tee
En Español (Spanish Version)

Definition | Reasons for Procedure | Possible Complications | What to Expect | Call Your Doctor

Definition

Pyeloplasty is a surgery to repair the kidney. Specifically, it repairs a part of the kidney called the renal pelvis. The renal pelvis is a funnel-like structure. It connects the kidney to a tube called the ureter. This tube 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 renal pelvis. This blockage prevents the urine from passing and makes the kidney swell.

Possible Complications

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

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

What to Expect

A physical exam will be done before surgery. The doctor may also require blood and urine tests.

The bowels will also need to be cleaned. Your diet will be limited to clear liquids the night before. Do not eat or drink on the morning of the surgery.

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

  • Anti-inflammatory medications such as ibuprofen
  • Blood thinners
  • Anti-platelet medications

General anesthesia will be given. You will be asleep.

Pyeloplasty may be done using open surgery or laparoscopic surgery. A catheter will be placed to allow urine to drain.

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

Laparoscopic surgery only requires a few small incisions. Special tools will be passed through these incisions to complete the surgery. The repair steps are the same as the open procedure above.

In some surgeries, a temporary tube may be placed in the ureter. This will allow urine to pass while the area heals.

About 2-3 hours

Anesthesia will block pain during the surgery. You may have some pain after the surgery. Your doctor will recommend medication to help you manage the pain.

The usual hospital stay is 2-3 days. Your doctor may choose to keep you longer if complications arise. The stay may be shorter if you had a laparoscopic surgery.

You will receive medication to ease discomfort. You may have some discomfort the first few times you urinate after surgery. It is also common to feel a frequent need to urinate. It will pass.

  • 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 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 for recovery.

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 medications 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 medications 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 for medical help right away.

RESOURCES:

American Academy of Family Physicians

http://familydoctor.org

Urology Care Foundation

http://www.urologyhealth.org

CANADIAN RESOURCES:

Canadian Urological Association

http://www.cua.org

References:

Pyeloplasty. Cleveland Clinic website. Available at: http://my.clevelandclinic.org/services/pyeloplasty/urology_overview.aspx. Accessed August 12, 2013.

Pyeloplasty FAQ. University of California San Francisco Benioff Children's Hospital website. Available at: http://www.ucsfbenioffchildrens.org/education/pyeloplasty/index.html. Accessed August 12, 2013.

Inagaki T, Rha KH, et al. 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.

6/3/2011 DynaMed's Systematic Literature Surveillance https://dynamed.ebscohost.com/about/about-us: 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 August 2013 by Michael Woods, MD

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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