PYELOPLASTY: effective treatment of hydroneephrosis, structure of the pelvic-ureteric junction
Our clinic has the best experience at reconstructive surgeries, annually 250 patients with hydro- and ureterohydronephrosis undergo the treatment
Laparoscopic reconstruction of the ureter and pelvis replaced open surgery. The new manual does not have blood loss, does not leave postoperative sutures. The hospital stay is not more then 4 - 6 days.
It is indicated in group of patients up to 65 years with the pelvic-ureteric junction stenosis, hydronephrosis.
Bilateral hydronephrosis and the threat of renal failure are absolute indications for the surgery
Laproscopic pyeloplasty is the most effective in the absence of significant expansion cups and intact kidney function.
Surgical intervention is not necessary in elderly patients in the case of normal function of the second kidney, stable function of the diseased kidney, as well as high operational and anesthetic risks.
In Department of Urology at Sechenov University laproscopic pyeloplasty is performed by MD with surgical experience more then 20 years
The most difficult stage is the formation of ureteropyelostomy, the correct connection of the pelvis and ureter after surgical removal of the narrowed area and the extended, non-contractible part of the pelvis. In order to create an airtight and functional fistula between the organs, from 12 to 20 (and sometimes more) sutures are applied with a thin, hair-like, suture absorbable material.
Microsurgical accuracy is ensured by modern endoscopic equipment Karl Storz, as well as wide-format optics Hopkins II.
The urine flow bypasses the healing zone, so a special drainage is installed in the upper urinary tract. In our clinic, polyurethane stents by a Danish company СOOK are used. It allow to create elastic and atraumatic curls for fixing the stent in the kidney and bladder. With that catheter, the patient can lead a normal life. Drainage is removed after a month under local anesthesia.
Due to the fact that the muscles of the pelvic organs are relaxed by anesthesia and can not for some time ensure the urine flow, just before surgery another drainage is brought into the bladder - a simple catheter. It is also needed to control the amount of urine excreted.
At the end of the operation, a third insurance drainage is established in the intervention zone. Wound discharge (mucus and blood residues) flows through it.
Insurance drainage and urethral catheter is removed after 2-3 days.
The operation time depends on the individual anatomical features and the condition of the patient's upper urinary tract. As a rule, laparoscopic plastic of the pelvic-ureteric segment takes about 2 hours. The patient is under endotracheal anesthesia, his respiratory function is supported by an anesthetic apparatus.
Cost of pyeloplasty – free for Russian citizens due to channel high-tech medical care
The cost of operation through paid medical services is around 130 thousands rubles. It is less than in other Russian and foreign urological departments.