Neurodiversity information for parents and young people
Removal of a kidney obstruction
This leaflet explains the operation to have an obstruction removed from your kidney. This is sometimes called a ‘pyeloplasty’.
We recommend this surgery to remove an obstruction which is stopping your kidney from draining well. The obstruction lies in the area where your ureter meets your kidney. The ureter drains urine (wee) from your kidney to your bladder.
This may be because:
- you were born with this condition
- you have had kidney stones
- you have some scarring from previous surgery or infection.
The operation usually takes 2 to 3 hours.
It is carried out under a general anaesthetic. This means you will be asleep throughout.
We will give you more information about the anaesthetic at your pre-operative assessment appointment.
About robot-assisted surgery
We perform this operation using keyhole (laparoscopic) surgery with robotic assistance.
Keyhole surgery means we insert a telescope and other instruments into your body through small cuts (instead of one large cut).
Robot-assisted surgery means the surgeon uses the robot to help perform the procedure. The robot does not operate by itself. It allows the surgeon to make more precise movements and do more complex surgery.
Read our leaflet to learn more about robot-assisted surgery and why we use a robot.
Benefits of this type of surgery
Traditional surgery to remove a kidney obstruction needs the surgeon to make a cut in the abdomen up to 30cm long. Keyhole surgery uses only a few small cuts (about the size of your fingertip). Sometimes we may need to make a larger cut, depending on the situation.
This means that robot-assisted keyhole surgery has many benefits, compared to traditional ‘open’ surgery.
Most patients go home the day after surgery, or within 1 to 3 days.
You are likely to return to normal activities sooner after keyhole surgery. Typically, this recovery period can range from 4 to 6 weeks.
Other benefits of keyhole surgery include:
- smaller scars
- less blood loss
- lower risk of infection
- less pain
- faster recovery
- lower risk of wound complications, such as urine leakage.
What to expect
Before your operation
A few weeks before surgery, you will have an appointment with the surgical doctors. They will explain the procedure and discuss the benefits and risks.
1 to 2 weeks before your operation, you will have a pre-operative assessment. This may include blood tests, heart checks and other tests. If you have other relevant medical conditions, you may see a consultant anaesthetist for more detailed checks.
We may give you two drinks to have on the morning of your surgery. We will explain this to you at your assessment.
On the day of surgery
On the day of surgery, we will admit you to the Kingston Hospital Admissions on the Day (AOD) Unit. If you have other health problems we may admit you the evening before surgery.
The anaesthetist will see you on the morning of surgery. The surgical team will also see you to obtain your consent for surgery. They will draw a mark on the side of your body where the surgery will take place.
They will ask you to change into a gown, and give you special socks to wear (like tight stockings). These will stop blood clots forming in your legs.
After the operation (in hospital)
After surgery, you may spend one night in a high-dependency unit, if needed.
We may give you:
- an oxygen tube in your nose
- a drip in your arm
- a wound drain to remove excess blood and fluid (which we usually take out after 1 to 2 days)
- a catheter (thin, flexible tube) to drain your bladder (which we usually take out after 1 day).
Eating and drinking
We will give you instructions about eating and drinking after your surgery. It is likely we will encourage you to drink and eat as you feel able. Some people start with fluids, before moving on to solid food.
Pain
You may feel mild pain, swelling or bruising around the surgery cuts.
You may get shoulder pain, due to the gas we use to inflate your abdomen during surgery. Your abdomen may feel bloated (swollen) or uncomfortable. These symptoms usually settle within a few days.
Getting moving
Our nurses or physiotherapists will help you to get out of bed and move around. If you can, do this first thing on the morning after your surgery. Gentle movement helps reduce post-operative complications and will speed up your recovery.
Going home
Most patients go home 1 to 3 days after surgery, depending on their recovery.
You may have stitches that dissolve (disappear naturally) or wound clips. If you have wound clips, you will need to arrange for your practice nurse to remove them 10 to 14 days after surgery.
Driving
You will not be able to drive yourself home after this procedure. We advise you to arrange for someone to drive you home and stay with you overnight.
Do not drive for 2 to 4 weeks after your operation. Only drive when you are not limited by pain and can react quickly enough to perform an emergency stop.
Recovery at home
You can expect the following while you recover at home.
| Pain, discomfort |
For most patients, their pain is often at its worst between day 2 and day 4 after the operation. Before you leave hospital, we will discuss appropriate pain relief with you. Some patients feel some irritation in the bladder, caused by the temporary stent which we insert during this operation (see Follow-up, below). |
| Washing and wound dressings | During the first week, take showers (not baths). Keep your wounds clean and dry. |
| Constipation | Patients often feel constipated (unable to poo freely). We will give you medicines (laxatives) to use if you need them. |
| Tiredness | You may feel tired for up to 2 months. This is normal. |
| Exercise |
We recommend gentle walking and light exercise. This will speed up your recovery. For 3 to 4 weeks, avoid heavy lifting, gym work, running, cycling or swimming. |
| Check your wounds |
Check your wounds for signs of infection, such as redness, swelling, pain or discharge. Contact your GP, district nurse or hospital team if you have any concerns. |
Follow-up
You can expect the following:
- 4 to 6 weeks after your procedure, we will arrange an appointment to remove your stent.
- 3 to 4 months after your procedure, we will arrange a scan to check your progress.
Risks of this operation
Risks during or shortly after surgery
| More common More than 15 in 300 patients |
|
| Less common Fewer than 15 in 300 patients |
|
| Rare Fewer than 3 in 300 |
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Risks after surgery
| Common More than 15 in 300 patients |
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| Less common Fewer than 15 in 300 patients |
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| Rare Fewer than 3 in 300 |
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| Rare 1 in 300 |
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More information
Contact information
Kingston Hospital Urology Department