What we see is that patients, as they get older, or even in their childhood can have actually congenital or acquired obstructions of the flow of urine from the kidney into the tube that drains it called the ureter. This is called a ureteropelvic junction obstruction. Now, there are different reasons for having ureteropelvic junction obstructions. It can be caused by a high insertion of the ureter into the kidney, which as you can imagine, may cause a kinking.

It can be caused by polyps inside the ureteropelvic junction, or it can be caused by a vessel that sits in front of the ureter that may cause it to not drain properly. What we need to evaluate, if you have symptoms of a ureteropelvic junction obstruction, which may include pain, decreased kidney function, recurrent infections in the urine that lead kidney infections. These are reasons why we may need to work up a ureteropelvic junction obstruction.

Now, say that you have one. We need to really define its anatomy and find out how it needs to be repaired. That’s why it’s important that you visit me as a reconstructive urologist. What I do is I carefully assess your kidney function, how it drains, and the cause of your ureteropelvic junction obstruction. If we find that it’s worthwhile to fix it, there’s a number of options.

Sometimes we can go with a minimally invasive option to fix your ureteropelvic junction obstruction. This may be by way of an endoscopy, meaning using a scope to go up there and either incise it with a laser or use a balloon to dilate the ureteropelvic junction obstruction. There are many ways to do this endoscopically. Now, if the ureteropelvic junction is not amenable for that kind of a repair and needs a formal repair with surgery, that can be reformed using a robotic approach. And what I suggest is that you come in and sit down with me to talk about your ureteropelvic junction obstruction. Now, what I will say is the use of robotics for the treatment of this condition and upper tract urinary reconstruction has made everything super easy.

Now, the anatomy may be variable. Maybe it’s a complicated case, but what the robot does is it makes it as easy as possible. And the way we do well with surgery is by making things simplified. What we have with a robot is magnification, wrist and hand movements. We’re able to delineate the ureter using special lenses on the robot that helps it glow green. We can see blood vessels better. We can use ultrasound to assess for blood flow. We can use all of these tools to really dissect out the kidney and repair the drainage of urine from the kidney into the ureter.

If you’re thought to have a ureteropelvic junction obstruction and you’re symptomatic, meaning that you have recurrent infections or you have pain. For example, after you drink a lot of water, These may be reasons why you need to see a urologist for a repair. Now, every once in a while, there’s a kidney that’s completely blown out that can’t be repaired, but we really need to sit down and evaluate the options.

If it looks like you have a healthy kidney, but it just has an issue draining, we may need to work it up further with special testing and consider a repair. If you have a ureteropelvic junction obstruction or would like talk about one, please make an appointment by either calling or visiting us at northwoodsurology.com.