Our overall goal in the Division of Urology in treating a UPJ obstruction is to preserve renal function. In some children, an ultrasound may show a significant amount of dilation (hydronephrosis) but the kidney functions and drains well. In this situation, we will closely follow your child with repeated imaging studies.
In situations where the kidney function is compromised, surgical intervention is needed. The surgical procedure to correct the obstruction is called a pyeloplasty. The area of obstruction in the ureter is removed and the normal area is reconnected to the kidney. Drainage tubes may be left in place to allow urine to flow across the surgical area to promote healing.
In young babies, the pyeloplasty is done through a small incision. Minimally invasive surgery (MIS) is an option for children older than 6 months. The pyeloplasty can be done either laparoscopically or through a robotic assisted laparoscopic approach. The minimally invasive approach is accomplished through three small incisions, the size of a grain of rice. The advantages are smaller, less visible incisions and a quicker recovery period. The minimally invasive technique is not appropriate for all children. Your healthcare provider will work with you and your family to determine what kind of intervention is best.