Why is this procedure done?
The urinary tract is made up of the kidneys, ureters, bladder, and urethra. Urine drains from the kidneys down tubes called ureters. They connect to the bladder. This is where urine is stored. When the bladder is full, it squeezes the urine out into the urethra and out of the body. ‚
Some illnesses can block the flow of urine out of the urinary system. This will make the urine go back to the kidneys and may cause injury to the kidney. You can have a blockage on just one side or on both sides. ‚
The surgery to repair the blocked or damaged part of a ureter at the kidney is a pyeloplasty. You may need this if your ureter is blocked or narrow. It may also be done if part of the urinary system is damaged. ‚
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What happens before the procedure?
- Your doctor will take your history. Talk to your doctor about:
- All the drugs you are taking. Be sure to include all prescription and over-the-counter (OTC) drugs, and herbal supplements. Tell the doctor about any drug allergy. Bring a list of drugs you take with you.
- Any bleeding problems. Be sure to tell your doctor if you are taking any drugs that may cause bleeding. Some of these are Coumadin ‚ ®, ibuprofen, Aleve ‚ ® (naproxen), or aspirin. Certain vitamins and herbs, such as garlic and fish oil, may also add to the risk for bleeding. You may need to stop these drugs as well. Talk to your doctor about them.
- When you need to stop eating or drinking before your procedure.
- Your doctor will do an exam and may order:
- Lab tests
- X-rays
- Ultrasound
- You will not be allowed to drive right away after the procedure. Ask a family member or a friend to drive you home.
What happens during the procedure?
- Once you are in the operating room, you will be given a drug to make you sleepy. It will also help you stay pain free during the surgery. The staff will put an I.V. in your arm to give you fluids and drugs. Your doctor will put a tube in your bladder to drain your urine
- This surgery may be done in one of two ways, open or laparoscopic.
- Open surgery:
- Your doctor will make a cut on your belly. Your doctor will cut the blocked part out and sew the ureter to the kidney.
- Laparoscopic surgery:
- Your doctor will make 3 to 4 small cuts in your belly. A scope with a tiny camera is put through one of the small cuts to look at the blocked area. Your doctor will put small surgical tools into the holes to do the procedure. To be able to view the site, gas will be put in the abdomen. Then, the blocked part will be removed.
- A special tube called a stent may be placed in your ureter. This will help it to stay open.
- The cut or cuts will be closed with stitches or staples and covered with a clean bandage.
- The procedure takes 2 to 3 hours.
What happens after the procedure?
- You will stay in the Recovery Room for up to 2 hours after surgery. You may have to stay in the hospital for 2 to 7 days based on the type of surgery done.
- The tube to drain your urine will stay in place for 2 to 4 days after your surgery and then it will be removed.
- You may have pain and numbness. Your doctor will give you drugs for this.
- Within a day or two, you will get out of bed to a chair. The staff will help you begin to walk around. Doing coughing and deep breathing exercises will help keep your lungs clear. You will get drugs to help with your pain.
What care is needed at home?
- Ask your doctor what you need to do when you go home. Make sure you ask questions if you do not understand what the doctor says. This way you will know what you need to do.
- Your doctor will give you drugs for pain and to prevent infection. Take them as ordered by your doctor.
- Talk to your doctor about how to care for your cut site. Ask your doctor about:
- When you should change your bandages
- When you may take a bath or shower
- If you need to be careful with lifting things over 10 pounds
- When you may go back to your normal activities like work, driving, or sex
- Be sure to wash your hands before touching your wound or dressing.
What follow-up care is needed?
- Your doctor may ask you to make visits to the office to check on your progress. Be sure to keep these visits.
- If you have stitches or staples, you will need to have them taken out. Your doctor will often want to do this in 1 to 2 weeks.
- If you have a stent, your doctor will set up a visit to check on your stent. Your doctor may remove this based on your condition.
- Your doctor may send you to a dietician to make a special diet for you. Your doctor will also tell what you can and cannot eat.
What lifestyle changes are needed?
You may have to limit your activity. Talk to your doctor about the right amount of activity for you. ‚
What problems could happen?
- Bleeding
- Infection
- Blood clots
- Blood pressure problems
- Injury to other organs
- Kidney failure
- A bulge in the belly (hernia)
When do I need to call the doctor?
- Signs of infection. These include a fever of 100.4 ‚ °F (38 ‚ °C) or higher, chills, pain with passing urine.
- Signs of wound infection. These include swelling, redness, warmth around the wound; too much pain when touched; yellowish, greenish, or bloody discharge; foul smell coming from the cut site; cut site opens up.
- No urine for more than 6 hours
- Very bad pain in your belly
- Weakness
- Upset stomach and throwing up
- Puffy eyelids and face
Helpful tips
- Use a small pillow to put pressure on your belly. This can make you more comfortable when you cough, laugh, or do other actions.
- It may take some time for your kidney to heal. Avoid caffeine, alcohol, and carbonated drinks during this time because they can bother your kidneys.
Where can I learn more?
American Urological Association Foundation ‚
http://www.urologyhealth.org/urology/index.cfm?article=43 ‚
Consumer Information Use and Disclaimer
This information is not specific medical advice and does not replace information you receive from your health care provider. This is only a brief summary of general information. It does NOT include all information about conditions, illnesses, injuries, tests, procedures, treatments, therapies, discharge instructions or life-style choices that may apply to you. You must talk with your health care provider for complete information about your health and treatment options. This information should not be used to decide whether or not to accept your health care providers advice, instructions or recommendations. Only your health care provider has the knowledge and training to provide advice that is right for you. ‚
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Copyright ‚ © 2015 Clinical Drug Information, LLC and Lexi-Comp, Inc. ‚