Pyeloplasty for PUJ Obstruction in Sharjah

What is pyeloplasty?

Pyeloplasty is a reconstructive operation on the upper urinary tract. Each kidney collects urine into a funnel called the renal pelvis, which narrows into the ureter, the tube to the bladder. When that junction is too tight, urine backs up and the kidney swells, a picture called hydronephrosis. The name for the condition is pelvi-ureteric junction (PUJ) obstruction, also written UPJ obstruction.

In pyeloplasty the surgeon removes the narrowed segment, trims the stretched funnel, and joins the healthy ureter back to the renal pelvis with a wide, funnel-shaped connection. The kidney itself stays whole, and the aim is to protect its function by letting it drain.

At Dar Al Kamal Hospital, Sharjah, pyeloplasty is performed in-house by the consultant urologist, either as keyhole surgery, described on the laparoscopic urology page, or through a small open incision, which is often chosen for young children.

Who needs it

PUJ obstruction appears at two stages of life, and each looks different.

In babies and children, the swollen kidney is often first seen on a pregnancy ultrasound. After birth, repeated ultrasound scans track it, and many of these kidneys improve on their own as the child grows. Pyeloplasty is advised when the swelling increases, the affected kidney's share of total function falls, or the child has pain or urinary infections. Care is shared with the pediatric urology team.

In teenagers and adults, the typical story is episodes of pain in the side or back that come on after drinking a large amount of fluid, as the kidney fills faster than it can drain. In Sharjah, where people drink heavily in the heat, this pattern is worth mentioning to your doctor. Other presentations include kidney infections, blood in the urine, or stones forming in the stagnant urine. A blood vessel crossing the junction is a common cause in adults.

Two tests guide the decision. An ultrasound or CT shows the swelling and the anatomy. A nuclear renogram, a scan arranged through nuclear medicine, measures how well each kidney works and how quickly urine drains. The urologist uses these with your symptoms to recommend surgery or continued monitoring, and explains other options such as a temporary stent where suitable.

What happens

Pyeloplasty is done under general anaesthesia. For keyhole surgery, the surgeon works through a few small incisions with a camera; for open surgery, through one small incision in the side or below the ribs.

The surgeon frees the renal pelvis and upper ureter, removes the narrowed junction, and shapes a new wide connection. If a crossing blood vessel is pressing on the junction, the ureter is rejoined in front of it so the vessel sits clear of the flow. The new join is stitched over a soft internal stent, a tube that runs from the kidney to the bladder and keeps the join open while it heals. A small drain and a urinary catheter are often placed for the first days.

Most people stay in hospital for a short period after pyeloplasty. Children stay with a parent, and pain relief is planned with the anaesthetist.

Preparing for it

A urine test checks for infection, which is treated first. You or your child have blood tests and an anaesthetic review. Bring previous ultrasound and renogram reports, especially any from pregnancy or early infancy, because the trend over time helps planning.

For children, explain the hospital stay simply and bring a comfort toy. Adults should arrange help at home and time off work. Raise Ramadan timing early so fasting and medicines can be planned.

Afterwards

The drain and catheter usually come out first. The internal stent is removed later, often with a short telescope check under a brief anaesthetic. Keep wounds clean and dry, which takes more care in the Sharjah heat, and drink steadily.

Follow-up scans compare the kidney's swelling and drainage with the scans before surgery. Swelling often reduces slowly, and the key measure is that urine now drains. Desk work, driving and manual work each follow their own timeline, which the urologist plans with you.

Contact the hospital urgently if you or your child has a fever, a wound that reddens or leaks, or new pain in the side. **Go to the emergency department straight away for a high fever with vomiting, severe side pain, or an inability to pass urine.**

Cost and insurance

Most UAE insurance plans cover pyeloplasty for confirmed PUJ obstruction, and it requires pre-approval supported by imaging and renogram reports. Stent removal and follow-up scans may be approved separately. Dar Al Kamal Hospital, Sharjah can help you confirm cover and start approval early on 06 599 7777.