This operation is done to open up a narrowing of the ureter. This is the tube that goes from patient's kidney to patient's bladder. A nephrostomy tube (a small drainage tube) is passed through an incision (cut) in patients back into patient's kidney.
A ureteric stent (small hollow, plastic tube) is then passed through the nephrostomy tube into the ureter. This stent makes sure that urine (pee) drains from the kidney to bladder. The nephrostomy tube may be removed after patient's stent is in place. Patient's stent will stay in place for a few weeks.
Endopyelotomy Stent
Used for temporary internal drainage from the ureteropelvic junction (UPJ)to the bladder following incision of a stricture.
The segment with no sideports prevents post operative narrowing of the ureteral lumen while preventing in growth of ureteral wall to the stent.
Highly radiopaque and has low encrustation tendency
Before Your Surgery
You will need to have a bath or shower the night before your surgery and another one in the morning. This is to cleanse your skin.
You should not eat or drink after midnight.
You should remove any make-up, jewellery, nail polish, false teeth, contact lenses, eye glasses and prostheses (false body parts).
Q. What does the procedure for Endopyelotomy Surgery involve ?
Two approaches are commonly used for Endopyelotomy; both these techniques are performed under general anesthesia.
Patient will be required to stay in the hospital for 2 days following the Endopyelotomy procedure : -
Antegrade Endopyelotomy : - In this procedure, the ureteropelvic junction of the kidney is approached from the side through the Nephrostomy tube. A blade is used to cut the UPJ and relieve the obstruction. The entire procedure takes about 2 - 3 hours. The nephrostomy tube is left in after Endopyelotomy.
Retrograde Endopyelotomy : - This procedure is performed by approaching the UPJ via the urethra. The Retrograde Endopyelotomy instrument contains a balloon that dilates and at the same time cuts to relieve the obstructed UPJ. This technique of Endopyelotomy is performed under general, regional or intravenous sedation. The entire procedure of Retrograde Endopyelotomy takes about 2 hours.
After Your Surgery
Your blood pressure, temperature, pulse rate and breathing will be checked often for the first few hours after your surgery. This is done for all patients who have surgery.
You will have an I.V. in your arm or hand.
If you have any pain, ask your nurse for pain medication.
You will be allowed to eat or drink when you feel well enough.
You should take 10 to 15 deep breaths and move your legs and feet every hour while you are awake. Do this until you are up and about.
Your nurse will help you get out of bed as soon as possible after your surgery. This is very important for your blood circulation and breathing. You will have a tube in your bladder to remove urine (pee).
The tube will stay in place for 1 - 2 days.
If you have a nephrostomy tube, it will be connected to a drainage bag.
If you do not have a nephrostomy tube, there will be a small bandage over the spot where the tube was.
Your bandage will be changed every day.
Benefits of Endopyelotomy Surgery : -
Short hospital stay
Quicker recovery
Less pain during post-operative period following Endopyelotomy
Less need for pain medication
Quicker return to normal activity and work
Smaller incisions and less scarring
The advantage of this approach is two fold. Primary placement of the stent helps to define the appropriate site and direction for the endopyelotomy incision, allowing marsupialization of the proximal ureter into the renal pelvis. Use of this technique also obviates the need to pass a large-caliber stent after the endopyelotomy incision has been made, thereby avoiding a potential risk of ureteropelvic junction disruption.
Risks of Endopyelotomy Surgery : -
Failure of the operation
Excessive bleeding
Infection (at the operation site or the urinary tract)
Injury to other organs and tissues
The list of of Urology Hospitals in India is as follows : -
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Used for temporary internal drainage from the ureteropelvic junction (UPJ)to the bladder following incision of a stricture.
The segment with no sideports prevents post operative narrowing of the ureteral lumen while preventing in growth of ureteral wall to the stent.
Highly radiopaque and has low encrustation tendency
