Surgery for Congenital Kidney & Urinary Tract Problems

Doctors at Hassenfeld Children’s Hospital at NYU Langone offer surgical treatments for children with congenital kidney and urinary tract defects. They can repair a blockage in one of the ureters, the tubes that drain urine from the kidneys to the bladder.

Our doctors can also perform a minimally invasive, endoscopic procedure using a cystoscope to correct vesicoureteral reflux, or urinary reflux, in which urine flows backward into the kidneys instead of draining into the bladder. Our doctors usually recommend surgery for children with urinary reflux only after they have tried less invasive cystoscopic treatments.

Surgery to repair a congenital kidney or lower urinary tract problem requires general anesthesia.

Pyeloplasty

Pyeloplasty is a procedure to remove a blockage in the ureteropelvic junction, the place where the ureters meet the renal pelvis—the part of the kidney that collects urine before it flows through the ureter. The urologist or surgeon removes the narrowed portion of the ureter and reattaches it to the renal pelvis.

In infants, pyeloplasty is often performed with open surgical techniques, requiring a small incision along the side of the abdomen. Sometimes, in older children, the surgeon performs this procedure using a laparoscope—a thin, lighted tube that’s inserted through a few tiny “keyhole” incisions—with assistance from a robotic device.

Robotic-assisted laparoscopic pyeloplasty takes longer to perform than open surgery, but the outcomes are the same. Older children and adolescents who are treated with robotic-assisted laparoscopic surgery may recover more quickly than those of a similar age who had open surgery.

Ureteral Reimplantation

Ureteral reimplantation is a procedure that is used to treat children who have persistent and severe urinary reflux, which can occur when a ureter is not positioned properly and urine flows back into the kidney. The procedure may also be used to correct reflux that may occur after puncturing a ureterocele that was previously blocking or obstructing the kidney.

In ureteral reimplantation, the surgeon makes an incision in the lower abdomen and bladder and disconnects the ureter from its current location in the bladder. If a ureterocele is present in the bladder, the doctor removes it and repairs the floor of the bladder. The ureter is then relocated to a more favorable position in the bladder. If both ureters contain a ureterocele, surgery may be required to repair both ureters. This procedure usually takes several hours to complete.

After Surgery

Most children who have pyeloplasty return home the next day. After ureteral reimplantation, a child may remain in the hospital for several days. Our doctors usually perform an ultrasound several weeks after any of these procedures to evaluate the kidney.

After kidney surgery, our doctors recommend regular checkups to ensure that your child’s blood pressure is under control and that there is no protein in the urine—which is a sign of poor kidney function.