OPD-Journey

A pyeloplasty is an operation to remove a blockage in one of the ureters.

• How does the urinary system work?

  The urinary system consists of the kidneys, the bladder and ureters. The kidneys filter the blood to remove waste products and form urine. The urine flows from the kidneys down through the ureters to the bladder.

  The ureters tunnel through the wall of the bladder at an angle to form a flap that acts as a valve. There is also a ring of muscle (sphincter) at the junction of the bladder and the urethra that stops urine leaking out in between pees.

  When peeing, the muscles of the bladder wall squeeze the urine out of the bladder, at the same time as the muscles in the sphincter need to relax to let the urine flow down the urethra.

  The valves between the ureters and bladder prevent urine flowing backwards into the ureters, so that all the urine in the bladder is passed in one go, as the urine cannot travel anywhere else.

  As the urine leaves the bladder at a high pressure, the valves stop this high pressure being passed on to the kidneys.

• Why is a pyeloplasty needed?

  The blockage in one of the ureters is stopping urine flowing easily from the kidney into the bladder. The blockage is usually present from birth, but occasionally may appear later.

  If the ureter remains blocked, the kidney could become swollen and damaged.

  Sometimes, the blockage is caused by blood vessels getting in the way of the ureter. In this case, they will be moved and secured away from the ureter during the operation, but not removed.

• What happens before the pyeloplasty?

  You will receive information about how to prepare your child for the operation in your admission letter. We will also invite you to come to a pre-admission clinic. This is an outpatient appointment where you will be able to discuss the operation with the team before coming in to hospital. Your child will also have various tests and investigations during this appointment. This avoids any delays on the day of the operation.

  On the day of the operation, your child should not have anything to eat or drink before the operation, for the amount of time specified in the letter. It is important to follow these instructions; otherwise your child’s operation may be delayed or even cancelled.

  Your child’s surgeon will visit you to explain about the operation in more detail, discuss any worries you might have and ask you to give your permission for the operation, by signing a consent form. An anaesthetist will also visit you to explain about the anaesthetic and pain relief after the operation. If your child has any medical problems, such as allergies, please tell the doctors. Please also bring in any medicines your child is currently taking.