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Pyeloplasty

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

Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems, like:
  • Bleeding
  • Infection
  • Hernia near the surgical site
  • Damage to tissues or organs
  • Persistent leakage of urine
  • Blockage of the ureter
Before your procedure, talk to your doctor about ways to manage factors that may increase your risk of complications such as:

What to Expect

Prior to Procedure

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.

Anesthesia

General anesthesia will be given. You will be asleep.

Description of Procedure

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

How Long Will It Take?

About 2-3 hours

How Much Will It Hurt?

Anesthesia will prevent pain during surgery. Pain and discomfort after the procedure can be managed with medications.

Average Hospital Stay

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.

Post-procedure Care

At the Hospital
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.
Preventing Infection
During your stay, the hospital staff will take steps to reduce your chance of infection, such as:
  • Washing their hands
  • Wearing gloves or masks
  • Keeping your incisions covered
There are also steps you can take to reduce your chance of infection, such as:
  • Washing your hands often and reminding your healthcare providers to do the same
  • Reminding your healthcare providers to wear gloves or masks
  • Not allowing others to touch your incision
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 after surgery.

Call Your Doctor

Call your doctor if any of the following occur:
  • Signs of infection, including fever and chills
  • Redness, swelling, increasing pain, excessive bleeding, or any discharge from the incision site
  • Persistent nausea and/or vomiting
  • 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
  • New or worsening symptoms
If you think you have an emergency, call for emergency medical services right away.

RESOURCES

Family Doctor—American Academy of Family Physicians http://familydoctor.org

Urology Care Foundation http://www.urologyhealth.org

CANADIAN RESOURCES

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

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

References

Pyeloplasty. Cleveland Clinic website. Available at: http://my.clevelandclinic.org/services/pyeloplasty/urology%5Foverview.aspx. Accessed May 13, 2014.

Pyeloplasty FAQ. University of California San Francisco Benioff Children's Hospital website. Available at: http://www.ucsfbenioffchildrens.org/education/pyeloplasty/index.html. Accessed May 13, 2014.

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 Available at: http://www.ebscohost.com/dynamed: 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.

Revision Information

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