Ureteral & Uretero-Pelvic Junction Treatment

Minimally-invasive techniques can drastically reduce recovery time.

Both endoscopic and laparoscopic procedures are minimally invasive techniques for treating ureteral and uretero-pelvic junction conditions that require surgery.

Technological advances allow these methods instead of traditional open surgery.
Benefits include quicker procedures, less pain, and shorter healing.

Endoscopic and Laparoscopic Treatments

Laparoscopy is one type of endoscopic surgery

Small camera tube is used for visualization

Fewer and smaller incisions than open surgery

Laparoscopy is actually one type of endoscopic surgery, the latter being a broader term for any type of minimally invasive surgery that involves using a small, flexible tube with a video camera and light on one end (an endoscope) for endoscopic procedures and a laparoscope for laparoscopic procedures. Laparoscopy involves making incisions in the abdomen. Other endoscopies are localized in other parts of the body and may or may not require incisions.

How These Procedures Are Performed

Minimally invasive access to the ureter and uretero-pelvic junction

For endoscopic treatment of ureter or uretero-pelvic junction conditions, a physician uses the camera tube to view the inside of the body and perform surgery without making the six- to 12-inch incision that is typical of open surgery.

In laparoscopic surgery, only one to three less than a half-inch incisions are made in the abdomen.

Tubing is inserted into the incisions to allow surgical access.

The surgical instruments and laparoscope slide through the tubing.

The surgeon views a video monitor while performing the procedure.

Surgery is performed on the ureter or uretero-pelvic junction.

Large open surgical incisions are avoided with these techniques.

Ureteral Stone Treatment

Stones are broken up if needed.

Fragments are captured with a small basket.

A stent is usually left temporarily.

The stent helps keep the ureter open.

Endoscopic treatment is often used to remove or break up kidney stones. For example, when stones are present in the ureter, a ureteroscopy can often be performed. An endoscope is inserted into the urethra, through the bladder and into the ureter without the need for incisions. Stones are broken up if needed, then captured and removed with a small basket. A stent is usually left in the ureter for a few days to a few weeks to help keep it open and allow the kidney to drain.

Uretero-Pelvic Junction Obstruction

Condition involves blockage at renal pelvis.

More common in children than adults.

May cause enlargement of renal pelvis.

Kidney damage may occur if untreated.

Laparoscopic surgery is also used to treat uretero-pelvic junction obstruction, a condition more common in children than adults. This involves a total or partial block of the junction between the kidney and ureter, called the renal pelvis. Since the ureter carries urine from the kidney to the bladder, the renal pelvis can become enlarged when it is blocked, and kidney damage may occur. If the obstruction doesn’t correct itself or respond to antibiotics, the blockage can be removed through laparoscopic pyeloplasty. The ureter is cut from the renal pelvis, the obstruction removed, and the ureter reconnected to the renal pelvis. A temporary stent is usually used to drain the renal pelvis and kidney as well.

What to Expect

Anesthesia and Hospital Stay

These procedures are performed under general anesthesia. A hospital stay of one to two days is typical after a laparoscopic pyeloplasty, but patients generally go home the same day after a ureteroscopy.

Postoperative Discomfort

Pain in the kidney area and when urinating is normal for up to a week and is managed by over-the-counter pain relievers.

Temporary Stent Sensations

Until the stent is removed, a feeling of fullness or urgency to urinate may be felt, but the body adjusts over time and the symptoms subside after removal of the stent.