Pyeloplasty is a kidney surgery to reconstruct a damaged ureter and renal pelvis. For adults the renal pelvis of the kidney and the ureters that lead down to the bladder becomes susceptible to being deformed when urine is built up in the urinary system, due to something blocking the urine and forcing it back up into the kidney(s). The uretero-pelvic junction (UPJ) obstruction can also be a congenital problem. Fetal ultrasounds can show in advance if a pyeloplasty is warranted early. This initial damage to the infant’s kidney is caused by hydronephrosis or built up pressure from trapped urine expanding the junction between the ureters and the kidney. Sometimes the kidney damage does not occur for years, if symptoms of uretero-pelvic junction obstruction do not present themselves early in life.
Pyeloplasty while often a pediatric procedure does need to be used for adults. Often the UPJ obstruction will be felt as kidney pain either from a kidney mass such as a kidney tumor or as symptoms of kidney stones. Either obstruction could create the UPJ obstruction that deforms the renal pelvis and ureter by creating dismembered pyeloplasty through the process of hydronephrosis which would call for the kidney surgery. Our Miami urologists Dr Alan Nieder and Dr Fernando Bianco the Chief of Robotic Surgery for the Columbia University Division of Urology at Mount Sinai Medical Center in Miami Beach Florida have experience in all three Pyeloplasty methods. They include open pyeloplasty, laparoscopic pyeloplasty, and minimally invasive robotic pyeloplasty.
Other injuries occur to the ureter and kidney that are caused by hydronephrosis deforming the renal pelvis, ureters, and even the entire kidney. Methods to remove the cause of the urinary retention include green light laser when the enlarged prostate symptom is brought on by benign prostatic hyperplasia (prostate enlargement) and bladder surgery such as a cystectomy or bladder tumor removal.
Pyeloplasty is a very successful kidney surgery with a 95% success rate. In more and more uretero-pelvic junction (UPJ) obstruction cases people are opting for the minimally invasive Robotic Pyeloplasty because not only does the laparoscopic small incision sites leave only very small scar tissue and less bleeding along with faster healing times but the Robotic surgery has the ability to create sutures superior to manual and standard laparoscopic suturing. The Robotic Pyeloplasty also gives the surgeon a magnified high definition 3D view of the surgery for very precise manipulation.