Pyeloplasty (PUJ Obstruction Surgery)

Pyeloplasty repairs a blockage where the kidney's collecting funnel, the renal pelvis, joins the ureter. This pelvi-ureteric junction (PUJ or UPJ) obstruction makes urine back up, stretches the kidney and can slowly damage it. The surgeon removes the narrow segment and rejoins the ureter to the renal pelvis with a wide, funnel-shaped connection.

It relieves pain, protects remaining kidney function and reduces infections and stones, with success in more than 90 percent of cases. It cannot restore function that has already been lost, and a kidney contributing very little may be better removed.

What Pyeloplasty (PUJ Obstruction Surgery) involves

Most adult operations are done by laparoscopic or robotic keyhole surgery through three or four small cuts in the abdomen. The bowel is moved aside to expose the kidney and upper ureter. If an artery crossing the junction is squeezing it, the ureter is repositioned in front of the vessel. In the standard Anderson-Hynes dismembered technique the narrowed segment is cut out, a baggy renal pelvis is trimmed, the ureter is opened lengthways and the two are sewn together with fine absorbable stitches over an internal plastic tube, a JJ stent. A small drain is left beside the repair for a day or two.

Who is a good candidate for Pyeloplasty (PUJ Obstruction Surgery)?

Surgery is advised when scans prove the junction is truly obstructed and it is causing symptoms or harming the kidney.

• Recurrent loin pain, often worse after drinking large volumes, with obstruction confirmed on a MAG3 renogram
• Falling split function of the affected kidney on serial scans
• Repeated kidney infections or stones forming behind the blockage
• Children with worsening hydronephrosis or reduced function on follow-up

It is usually not the right choice if:

• A dilated kidney that drains well on a renogram, which can simply be monitored
• A kidney contributing less than about 10 to 15 percent of total function, where removal may be advised
• An active urinary infection, which must be treated first
• People unfit for general anaesthesia, who may be managed with a long-term stent

Technique options

• Robotic or laparoscopic dismembered pyeloplasty: The usual choice for adults and older children. Small wounds, 1 to 3 nights in hospital and success above 90 percent.
• Open pyeloplasty: A small flank incision, still common in infants and in complex redo surgery.
• Endopyelotomy: The narrowing is cut from inside with a laser or blade via the ureter. Less invasive but less successful, so reserved for selected or failed cases.
• Flap pyeloplasty: Used when the narrowed segment is long, to bridge the gap with a flap of renal pelvis.

What happens during your treatment

Surgery takes 2 to 3 hours under general anaesthesia. You wake with a bladder catheter and a small wound drain, both normally removed within 1 to 2 days. Pain is usually moderate and controlled with tablets after the first day. The internal stent can cause bladder urgency and a pulling feeling in the flank when you pass urine.

Preparing for your trip

Plan for 7 to 10 days in Istanbul. Your surgeon reviews photographs and your medical history before you book, and you meet in person the day before surgery for examination, marking and consent with a professional interpreter.

• Stop smoking and nicotine at least four weeks before and after surgery; it is the single biggest avoidable cause of wound problems
• Tell the team about every medicine and supplement you take; blood thinners, some herbal products and hormone treatment may need to be paused on your doctor's advice
• Arrange for someone to travel with you or to be reachable, and keep the first days at home free of work and lifting
• Book a changeable return flight; your surgeon confirms when you are fit to fly

Recovery and results

Hospital stay is 1 to 3 nights after keyhole surgery. Light activity is possible within a week and office work at about 2 weeks; avoid heavy lifting for 4 to 6 weeks. The stent is removed through a brief flexible cystoscopy after 4 to 6 weeks. A renogram or ultrasound at around 3 months, and again at a year, confirms that the kidney now drains freely.

• Back to everyday activity: 2 weeks
• When results show: Pain relief after the stent comes out at 4 to 6 weeks
• How long they last: Permanent in more than 90 percent

Safety, risks and revision policy

Pyeloplasty is reliable, but it is a delicate join that occasionally leaks or narrows again.

• Urine leak from the repair, usually settling with longer drainage
• Recurrent narrowing in roughly 5 to 10 percent, which may need a second procedure
• Urinary infection, more likely while the stent is in place
• Stent discomfort, urgency and blood in the urine
• Bleeding or injury to bowel or nearby vessels, which is rare
• Conversion from keyhole to open surgery
• Persistent pain in a few people even though drainage is improved

Every written proposal arranged through Clinic-Y states what the clinic covers if a correction is needed. Ask for it before you book, not after.

Cost of Pyeloplasty (PUJ Obstruction Surgery) in Türkiye

Clinic-Y does not publish a single price for Pyeloplasty (PUJ Obstruction Surgery), because the honest figure depends on your case. What moves it:

• Robotic, laparoscopic or open approach
• Length of hospital stay
• Pre-operative imaging such as a MAG3 renogram and CT urogram
• Stent removal and follow-up scans
• Redo surgery, which is longer and more complex

Send your photographs or reports and you receive written, all-inclusive proposals from suitable teams, side by side. Reviewing your case is free.

Frequently Asked Questions