Thursday, 18 February 2016

Laparoscopic Pyeloplasty - Are you ready for the surgery?

What is pyeloplasty?

Pyeloplasty is the surgery for revision or reconstruction of the renal pelvis to decompress and drain the kidney. Generaly this surgery is performed if the renal function is not performing adequately then it is done to treat the uretero-pelivic junction. This surgery for revision of the renal pelvis or complete or reconstruction of renal pelvis is excising the uretero-pelvic junction and stenotic region of the renal pelvis to treats the obstruction and develop more capable conduit with the help of remaining renal pelvis and ureter tissues.


Why does my child need a pyeloplasty?

If in any scenario the child is experiencing the blockage at the portion where the ureter and renal pelvis got connected with each other. It is the region where the tube carries out the urine from kidney to bladder. This narrowing and blockage leads to the kidney dilation, which in medical terms called the condition of hydronephrosis. This condition can usually be diagnosed with the help of kidney scan and ultrasound.

Where is the incision?

There are various angles to perform this surgery. Generally the incision or cut will be done on your child’s side. Before the surgery, the surgeon is going to discuss the location of the incision with you and after the discussion the most appropriate location will be decided mutually for the surgery. All the sutures (i.e. stitches) will dissolve automatically.

How long will the surgery take?

The pyeloplasty surgery generally takes 2-3 hours. During the surgery you will continuously get the update regarding the surgery from the nurse or the assistant doctor.

Will my child have problems urinating after surgery?

After this surgery, as the bladder catheter, it is very usual feeling or need in children to urinate frequently and also experience some kind of discomfort during urination for initial few times. Make your children to sit in the tub filled with warm water will provide them some relief. Placing a warm and damp washcloth on the skin between scrotum and anus in male child and between vulva and anus in female child can also provide some relief and make your child feel more comfort.

What kind of side effects do the medications have?

Many Children do not like this surgery procedure. Some of the medications are prescribed to child after surgery like Demerol, Droperidol or Morphine. Here are some of the side-effects that a child can experience due to these medications:

1.   children drowsy
2.       children react differently
3.       become overexcited
4.       nervous
5.       develop a rash
6.       Constipation


What is the follow-up after surgery?

Generally the child has to stay at hospital for a day or two after the surgery. If any catheter or drain is placed, then an appointment should be made within a week after surgery to remove it. If no catheter is placed then you can schedule an appointment in 4 weeks after the surgery. It is crucial and need assistance that the child has to take antibiotics till this time after surgery.
The child has to be schedule for ultrasound scan of the kidney for 1-2 months, to continuously diagnose if any kind of blockage is at the site of the surgery. Children who have the pyeloplasty surgery done might get urinary tract infections. If you see any kind of symptoms of the infection, please contact the pediatricians as soon as possible.

Check the list, if your children have any of these symptoms then please contact the pediatricians:
  •    Difficulty urinating
  •   Excessive bleeding
  •  Vomiting
  •  Return of symptoms experienced prior to procedure
  •  Extreme irritability
  •  Temperature greater than 101° F


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