Robotic-assisted ureterolysis and pyeloplasty are two procedures to remove a blockage in the ureter or the ureteropelvic junction (UPJ). Ureterolysis may be done when a ureter is blocked by something outside of the ureter. Usually, the blockage is caused by scar tissue pushing against the ureter, which squeezes (constricts) the ureter closed. Scar tissue may be the result of previous surgery, infections, or inflammation. During ureterolysis, the ureter is moved away from the scar tissue to open the ureter, but the scar tissue is not removed.
Pyeloplasty may be done when the ureter is blocked or constricted by something inside of the UPJ. The blockage may be caused by scar tissue, a fluid-filled sac (cyst), a growth, or a kidney stone. The blockage may also be caused by a blood vessel crossing in front of the UPJ. During pyeloplasty, the blockage is removed, unless the blockage is caused by a blood vessel. If the blockage is caused by a blood vessel, the blood vessel is moved away from the UPJ.
Tell a health care provider about:
- Any allergies you have.
- All medicines you are taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.
- Any problems you or family members have had with anesthetic medicines.
- Any blood disorders you have.
- Any surgeries you have had.
- Any medical conditions you have.
- Whether you are pregnant or may be pregnant.
- Allergic reactions to medicines.
- Damage to other structures or organs, such as the ureter or the intestines.
- A return of the urine blockage.
- Urine leakage.
- Blood clots.
- Make sure you understand the type of procedure that you are going to have. During the procedure, the robotic-assisted procedure may be stopped and an open surgery may be started. An open surgery means that the surgeon will make a larger incision and perform the procedure by hand. Your surgeon will decide if this is necessary during the procedure. If you have questions, talk with your health care provider.
- Ask your health care provider about:
- Changing or stopping your regular medicines. This is especially important if you are taking diabetes medicines or blood thinners.
- Taking medicines such as aspirin and ibuprofen. These medicines can thin your blood. Do not take these medicines before your procedure unless directed by your health care provider.
- Follow instructions from your health care provider about eating or drinking restrictions.
- You may be asked to bathe or shower using a soap that kills skin bacteria.
- Ask your health care provider how your surgical site will be marked or identified.
- You may be given antibiotic medicine to help prevent infection.
- You may have an exam or testing.
- You may have a blood or urine sample taken.
- Plan to have someone take you home after the procedure.
What Happens During The Procedure?
- An IV tube will be inserted into one of your veins.
- You will be given a medicine to make you fall asleep (general anesthetic). You may also be given a medicine to help you relax (sedative).
- A thin, flexible tube (catheter) will be passed through your urethra and into your bladder. The catheter will drain urine from your bladder during the procedure.
- Several small incisions will be made in your abdomen.
- A thin tube with a light and a small camera on the end (laparoscope) and other surgical instruments will be passed through your incisions to perform the procedure.
- Carbon dioxide gas may be put into your abdomen. This stretches your abdomen so that your surgeon can see your organs.
- If a pyeloplasty is done, the blockage will be removed by making an incision in your ureter or your UPJ and removing the blockage, or by moving the blood vessel causing the blockage.
- In some cases, part of your ureter may be removed, or you may need to have a soft plastic tube (stent) inserted into your ureter to prevent urine from draining out of the incision in your ureter while the incision heals.
- If an incision is made in your ureter or your UPJ, your incision will be closed with stitches (sutures).
- If a ureterolysis is done, your ureter will be moved away from the source of the blockage. You may not need a stent.
- If necessary, kidney stones will be removed.
- A drainage tube may be placed in your abdomen.
- The incisions in your abdomen may be closed with sutures, skin glue, or adhesive tape.
Post Procedure Care
- Your blood pressure, heart rate, breathing rate, and blood oxygen level will be monitored often until the medicines you were given have worn off.
- You may continue to receive fluids and medicine through an IV tube.
- You will have some pain. Pain medicines will be available.
- You will be encouraged to walk around as soon as possible.
- You may have to wear compression stockings. These stockings help to prevent blood clots and reduce swelling in your legs.
- You will have a catheter draining your urine.
- You may have a tube draining fluid from your surgical area.
- You may be kept on a liquid diet. You may not be able to eat solid food until you pass gas or have a bowel movement.
- Do not drive for 24 hours if you received a sedative.
This information is not intended to replace advice given to you by your health care provider.