A blockage where the kidney drains into the ureter, called the pelviureteric junction (PUJ) obstruction, can cause pain, recurrent infections, and gradual damage to kidney function. Robotic pyeloplasty is a minimally invasive surgical repair that corrects this obstruction with success rates of around 95%, and is regarded as the gold-standard treatment for PUJ obstruction.
TREATMENTS
Robotic Pyeloplasty
Understanding PUJ Obstruction
A PUJ obstruction may be present from birth or develop later in life, and can affect one or both kidneys. Intervention is recommended when:
• The obstruction is causing recurrent flank pain, especially after drinking large volumes of fluid
• Kidney function is impaired or declining on nuclear medicine scans (DTPA/MAG3)
• There are recurrent urinary tract infections or stone formation related to impaired drainage
Surgical Options
• Robotic dismembered pyeloplasty: Robotic precision aids excision of the narrowed segment and preservation of any crossing blood vessel. The ureter is rejoined to the kidney with a wide join to prevent repeat narrowing.
• Laparoscopic pyeloplasty: A minimally invasive keyhole alternative used in selected cases.
• Endopyelotomy: An endoscopic incision of the narrowed segment — using laser or balloon via a ureteroscope. It has somewhat lower success rates but is less invasive.
Risks and Considerations
All procedures carry risks, which your surgeon will discuss with you in detail. These may include:
• Temporary urine leak while the join heals
• Recurrent narrowing (around 2–5%) — long-term imaging follow-up is arranged
• Stent-related bladder irritation until the stent is removed
Recovery at a glance: Usually 1–2 nights in hospital; the internal ureteric stent is removed around 6 weeks. Resumption of normal activities around 4-6 weeks.
1
Pre-Operative Planning
Nuclear medicine renography (DTPA/MAG3) and CT urography are used to confirm the obstruction, assess each kidney's function, and plan the surgical approach.
2
Minimally Invasive Repair
The procedure is performed through small incisions with robotic assistance, providing precision for delicate suturing deep in the retroperitoneum.
3
Reconstruction and Stenting
The narrowed or obstructed segment is removed and the ureter is re-joined to the kidney's drainage system. A temporary stent supports healing for 4–6 weeks.
4
Outcome Monitoring
Post-operative scans and blood tests confirm resolution of the obstruction and recovery of kidney function.
Our Approach
