Is your kidney's ureter blocked? Let's talk about this Pyeloplasty surgery!

You may sometimes wonder how smoothly our body's systems work without us even realizing it. But imagine what would happen if the fine tube that produces urine from the kidneys, which goes down to the bladder, got blocked somewhere? That's the kind of blockage that often causes kidney pain and swelling. One treatment for this is a surgery called 'Pyeloplasty'. Don't worry, we'll talk about everything simply and clearly.

Simply put, what is Pyeloplasty?

To understand this, let's first take a look at how our urinary system works. Urine is produced by the two kidneys in our body. The urine that is produced in this way collects in a funnel-like part inside the kidney. We call this `(Renal Pelvis)`. Then, this urine goes down a thin tube and collects in the bladder. This tube is called `(Ureter)`.

Now imagine that there is a blockage or obstruction at the point where the kidney's funnel (`Renal Pelvis`) and the tube that starts from it (`Ureter`) connect, that is, at the `(Ureteropelvic Junction - UPJ)`. What happens then? The urine cannot go down and starts to fill up inside the kidney. Just like when a water pipe gets stuck in the middle, the water fills up backwards. This causes the kidney to swell , which doctors call `(Hydronephrosis)`. Also , there may be pain in the back, frequent urinary tract infections, and over time, the kidney may even be damaged .

Who really needs this surgery?

This condition, called ``UPJ'' obstruction, is sometimes congenital. On average, about one in 1,500 children are born with this condition. However, in most cases, it resolves on its own by the time a child is 18 months old. If it persists, such as if the kidney continues to swell or become infected, doctors may recommend surgery.

Also, this condition can occur later in older children, young adults, and adults. If your doctor sees that your kidney is swollen (Hydronephrosis) on an ultrasound or CT scan, they may suspect that the cause is a blockage in the UPJ. This surgery may also be necessary.

How is this surgery done? Do you make a large incision?

No. With today's advanced technology, this is often done with very small incisions . But there are several methods. Let's see what they are.

What should you do before surgery?

Your doctor will give you instructions on how to prepare for your surgery, and it is very important to follow them exactly.

• Fasting: You will be asked to refrain from eating or drinking for about 8 hours before the surgery.
• Medications: If you are taking any other medications, ask your doctor if you should stop taking them or if you can take them with a sip of water. Do not stop taking any medications without medical advice.
• Someone to help you: You will need to stay in the hospital for a day or two after the surgery. Arrange in advance for someone to accompany you home.

What can you expect after surgery?

You will usually have to stay in the hospital for one or two days. During this time:

• You can eat and drink normally after surgery.
• You can walk around a bit, move around a bit. But it's important to rest, as the doctor says.
• Antibiotics are given to prevent infections.
• A Foley catheter may be placed. It will be removed when you go home.
• The surgery may cause swelling of the urethra, which can cause some pain and bladder spasms. The doctor will provide the necessary painkillers for this.

What does it mean to place a stent?

Often, during this surgery, a very thin plastic tube is placed inside the newly connected ureter to hold it open until it heals. This is called a `(Stent).` This is something that is placed temporarily. This `(Stent)` is removed after the kidney heals in a few weeks.

What are the benefits and risks?

As with any surgery, there are benefits and risks involved. Your doctor will explain these to you in detail.

Recovery time and how to take care at home

You will usually start to feel better within a week or two . Until the stent is removed, you may experience some pain when urinating and a little blood in your urine. This is normal. You will be able to return to your normal activities in about three to four weeks .

Take care of these things at home:

• Drink plenty of water. It is very good to drink at least 2-3 liters of water a day.
• Take the medications (painkillers, antibiotics) prescribed by the doctor on time.
• Remove the bandage from the incision as directed by your doctor. Keep it clean and dry.
• Avoid bathing in a sink. It can cause infections. It's okay to take a shower.
• Avoid lifting weights or doing strenuous work for four to six weeks.

When should you see a doctor immediately?

• Persistent nausea or vomiting .
• Signs of infection such as fever , redness around the incision, swelling, and pus drainage.
• Severe pain that cannot be controlled even with medication.
• If the urine is dark red and has heavy bleeding with clots.
• If you experience chest pain or difficulty breathing , go to the nearest hospital's Emergency Department (ETU) immediately.

This surgery is more than 95% successful, meaning nine out of ten people. So there is no need to worry about this. But if the doctor says that you or your child needs this surgery, talk to him about any questions, fears, or doubts you have about it. That way, you will have a better understanding and peace of mind.

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