Urethral pelvic junction obstruction is a common urological disorder. It affects many individuals in the world. It develops due to blockage of the junction between the pelvis and an ureter. This condition affects the normal function of a kidney in certain cases. It can cause kidney stones, nausea and vomiting etc., health conditions in patients.

Its best surgical treatment approach is Endopyelotomy. This surgery involves the treatment of a blockage, which occurs in the renal pelvis. It is an endoscopic surgery that is performed under general anesthesia. The requirement of open surgery is avoided from this surgical technique. It can be performed in many healthcare departments in India.

Types of Endopyelotomy

This surgery is of different types. These include the following:

Antegrade Endopyelotomy: In this surgery, a surgeon makes a small incision in the skin to access the kidney. This treatment is preferred for patients suffering from pyeloplasty failure, upper tract stones etc.
Retrograde Endopyelotomy: This procedure involves a tiny telescope which is passed through the urethra. It is less invasive than antegrade endopyelotomy.

Benefits

The advantages of this surgery are as follows:

It restores normal urine flow to minimize kidney damage risk and improves kidney functions in patients.
This method is minimally invasive which results in less trauma as compared to open surgery.
It consumes less time and provides faster recovery in individuals.
The large incisions are avoided from this surgical technique, which may result in less pain and discomfort in patients.
It is cost-effective and can be performed as an outpatient procedure.

Risks and Complications

Endopyelotomy is considered a safe and effective procedure, but can cause several complications after surgery. These include the following:

Leakage from ureter or renal pelvis
Failure of an operation
Discomfort or blockage in urinary stent
Injury in urinary wall and bladder
Allergic reactions
Cardiovascular issues
Bleeding and Infection
Recurrence of Ureteropelvic Junction

Who is Eligible for this Surgery?

This surgical procedure is recommended for patients who suffer from the following health conditions:

Recurrent Flank pain
Trauma
Congenital narrowing or blockage in ureteropelvic junction
Hydronephrosis
Failed Pyeloplasty
Recurrent Urinary Tract Infections
Hematuria

Patients with acute trauma, extensive tissue damage etc., are not suggested for this surgical procedure. They must consult with a relevant doctor for the management of these health conditions.

Before Procedure

The things that may be expected before the surgery are as follows:

The medical history, current medications and other symptoms will be discussed in the healthcare department.
The foods and drinks are avoided for 10 or 12 hours before the surgery.
An individual must remove certain essential items such as jewelry, contact lenses, etc.
Smoking cigarettes or tobacco must be avoided for at least one week.
An individual should prepare their skin through bathe or showering.

A healthcare provider will perform some tests before the surgical procedure. These include the following:

Diuretic renography: It evaluates the renal function of a kidney.
Urinalysis: The white and red blood cells are identified before surgery.
Intraluminal ultrasonography: It is an imaging study in which the location and extent of an obstruction can be identified.
Magnetic Resonance Urography: It evaluates the structure and function of the kidneys, ureters and bladders.
Endoluminal Ultrasonography: A flexible catheter is used with a high frequency transducer for the evaluation of blocked ureters.

During Procedure

This surgery may be performed in certain steps. These are as follows:

A patient will be positioned on the operating table and the small and flexible tube known as endoscope is inserted into the urethra.
The small surgical instrument is attached with an endoscope. After that, a surgeon makes a small incision in the blockage area.
A stent is placed in the ureter carefully, which supports the rehabilitation process and minimizes the postoperative headaches in patients. It was then removed by an urologist after a few weeks.
Once the surgery is completed, the sutures are used to close the incision.

After Procedure

The following things that can be expected after the surgical procedure:

A patient will be taken into the recovery room and their pulse rate, blood pressure, temperature and breathing will be determined for a few hours.
An intravenous injection will be applied in an arm or hand.
A medication drug will be provided to a patient when he or she suffers from pain while urinating.
Certain activities such as jogging, playing sports and heavy-lifting objects should be avoided for two weeks.
If severe pain or burning occurs while urinating then consult with a relevant doctor immediately.

Endopyelotomy Treatment