Kidneys are the amazing little organs that filter waste from our blood, producing urine. Urine then travels down thin tubes called ureters to the bladder. But sometimes, this drainage system can get blocked, especially in children. This blockage, at the junction of the kidney and ureter, is called Uretero-Pelvic Junction Obstruction (UPJO) and can lead to a condition called hydronephrosis.

Hydronephrosis simply means a swollen kidney. When urine can’t drain properly, it backs up into the kidney, causing it to enlarge. While this may not cause immediate symptoms, it can affect long-term kidney function if left untreated. Thankfully, there’s a surgical solution called pyeloplasty that can help children with hydronephrosis.

What is Pyeloplasty?

Pyeloplasty is a minimally invasive surgery that fixes the blockage at the UPJ. Surgeons can perform this procedure in two main ways:

• Laparoscopic Pyeloplasty: This is the preferred method. Tiny incisions are made in the abdomen, and a laparoscope (a thin, lighted tube) is inserted to view the kidney and ureter. Surgical instruments are then passed through other small incisions to perform the repair.
• Open Pyeloplasty: In some cases, an open approach may be necessary. This involves a single larger incision in the abdomen to access the kidney and ureter directly.

During the surgery, the surgeon essentially widens the narrowed junction, allowing urine to flow freely again. The procedure usually takes 1-2 hours, and most children can go home the same day or the next day.

Benefits of Pyeloplasty for Children

Pyeloplasty is a highly successful surgery with a success rate exceeding 90%. Here’s why it’s a great option for children with hydronephrosis:

• Preserves Kidney Function: By relieving the blockage and preventing further kidney damage, pyeloplasty helps ensure healthy kidney function in the long run.
• Minimally Invasive: Laparoscopic pyeloplasty offers quicker recovery times and less pain compared to an open approach.
• Safe and Effective: Pyeloplasty is a well-established surgery with a good safety profile.

Who Needs Pyeloplasty?

The decision for pyeloplasty depends on the severity of the UPJO and its impact on the kidney. Your child’s doctor will consider factors like:

• The degree of kidney swelling
• Changes in kidney function
• Presence of symptoms like pain or urinary tract infections

If you have any concerns about your child’s health, consult a pediatric urologist. They can provide more specific information about pyeloplasty and determine if it’s the right course of treatment for your child.