The most severe cases of ureteropelvic junction obstruction may require surgery early in life, while many do not require early surgery. The majority of cases do not require surgery at all, but do need to be checked up periodically until the obstruction has gone away.
Regular testing is required to make sure the kidney is still functioning properly. If the function of the kidney appears to be getting worse, or the obstruction is getting worse, surgery may be recommended.
Surgery to correct the blockage allows urine to flow normally, and can be performed using open methods (incision) or laparoscopic methods. Both methods are called a pyeloplasty and involve removing the abnormal part of the ureter and reconnecting it to the kidney to permit normal urine flow.
Open surgery is performed at all ages, and involves an incision in the side or back to get to the kidney and remove the blockage, then repair the ureter.
Laparoscopic surgery using the surgical robot, a minimally invasive technique, can now be used in all ages, and usually involve the assistance of robotic surgery to help with the delicate repair. The success rates of both are similar, but children having a laparoscopic procedure can usually return home sooner (one day) and are back to normal activity sooner.
A tube called a stent may be placed to drain urine from the kidney until the patient heals. A nephrostomy tube, which is placed in the patient's side to drain urine, may also be needed for a short time after the surgery. This type of tube may also be used to treat severe infections before surgery.