How it shows up
Classically as intermittent flank pain that worsens after drinking a large volume of fluid or alcohol. Often it is found on a scan as unexplained hydronephrosis with no stone to account for it, sometimes carried silently since childhood.
- Recurring dull or colicky flank pain
- Hydronephrosis on ultrasound without a stone
- Reduced function on that side on a renal scan
- Repeated urine infections
- Stones forming in the obstructed kidney
Deciding whether to operate
Not every dilated kidney is obstructed. A diuretic renogram (DTPA or EC) measures drainage and split function, and that test, not the ultrasound picture alone, decides. Surgery is advised for symptomatic obstruction, declining function, infection or stone formation.
The repair
The narrowed segment is excised and the renal pelvis is re-joined to the ureter as a wide funnel over a DJ stent. Done laparoscopically or robotically through small ports, this gives long-term success rates above 90%. Hospital stay is two to three days; the stent is removed after four to six weeks, and a repeat renogram at three months confirms drainage has improved.
Pyeloplasty (PUJ Obstruction) — common questions
Can PUJ obstruction be treated without surgery?
Mild, non-progressive cases with good function can be watched with periodic scans. Once pain, infection, stones or falling function appear, surgery is the treatment.
Will kidney function recover after pyeloplasty?
Function usually stabilises and often improves modestly. How much comes back depends on how long the obstruction was present.
Is pyeloplasty done by keyhole surgery?
Yes, laparoscopic and robotic pyeloplasty are standard, with results equal to open surgery and a much easier recovery.
What if the obstruction recurs?
Recurrence is uncommon. When it happens it can be managed with endopyelotomy or a redo repair.
Reviewed by Dr. Kinjal Banerjee, MBBS, MS (General Surgery), DNB (Urology) — Urologist, Renal Transplant & Robotic Surgeon, Faridabad. This page explains pyeloplasty (puj obstruction) in general terms; your own treatment plan depends on your reports and examination.