Our Summary

This research paper is about a common kidney condition in children called ureteropelvic junction obstruction (UPJO), which often leads to a kidney disorder known as hydronephrosis. The traditional method to treat UPJO was through a type of surgery first introduced in 1949. However, recent advancements in technology have led to the use of less invasive procedures, specifically robotic assisted laparoscopic pyeloplasty. This paper reviews how this new technique is used in children. Past studies have shown that this procedure has over a 90% success rate, with similar rates of complications as the traditional method. Therefore, the use of this less invasive procedure is likely to become more popular in the future.

FAQs

  1. What is ureteropelvic junction obstruction (UPJO)?
  2. What is the success rate for robotic assisted laparoscopic pyeloplasty in pediatric patients?
  3. How does the complication rate of robotic assisted laparoscopic pyeloplasty compare to the open approach?

Doctor’s Tip

A helpful tip a doctor might tell a patient about pediatric urologic reconstruction is to ensure that the child follows post-operative care instructions carefully, including taking any prescribed medications, attending follow-up appointments, and avoiding strenuous activities as recommended. It is also important for the child to stay well-hydrated and to report any concerning symptoms or issues to their healthcare provider promptly.

Suitable For

Patients who are typically recommended for pediatric urologic reconstruction are those with ureteropelvic junction obstruction (UPJO) causing hydronephrosis. This condition is common in the pediatric population and may require surgical intervention to alleviate symptoms and prevent long-term complications. In particular, patients who have not responded to conservative management or who are at risk for renal damage may be candidates for pediatric urologic reconstruction. Robotic-assisted laparoscopic pyeloplasty is a minimally invasive approach that has been shown to be effective in treating UPJO in children, with success rates exceeding 90%. This approach is often recommended for patients who are suitable candidates for minimally invasive surgery and have a favorable prognosis.

Timeline

Before pediatric urologic reconstruction:

  1. Patient presents with symptoms of ureteropelvic junction obstruction (UPJO) such as flank pain, urinary tract infections, or hematuria.
  2. Diagnosis is confirmed through imaging studies such as ultrasound, CT scan, or MRI.
  3. Treatment options are discussed with the patient and their family, including open dismembered pyeloplasty or minimally invasive approaches such as robotic assisted laparoscopic pyeloplasty.
  4. Surgical team discusses the risks and benefits of the procedure with the patient and their family, and consent is obtained.

After pediatric urologic reconstruction:

  1. Patient undergoes robotic assisted laparoscopic pyeloplasty, where the blocked portion of the ureteropelvic junction is removed and the remaining healthy ureter is reattached to the renal pelvis.
  2. Patient is monitored in the recovery room and may stay in the hospital for a few days for observation.
  3. Patient is discharged home with instructions for post-operative care, including pain management and follow-up appointments.
  4. Patient follows up with their urologist for regular check-ups and imaging studies to monitor the success of the surgery.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with pediatric urologic reconstruction surgery?
  2. How long is the recovery period after pediatric urologic reconstruction surgery?
  3. What kind of follow-up care will be needed after the surgery?
  4. Are there any long-term effects or implications of pediatric urologic reconstruction surgery?
  5. What alternative treatment options are available for pediatric urologic reconstruction?
  6. How experienced are you in performing pediatric urologic reconstruction surgery?
  7. What is the success rate of pediatric urologic reconstruction surgery in your practice?
  8. How will the surgery impact my child’s daily activities and quality of life?
  9. Are there any specific dietary or lifestyle changes that my child will need to make after the surgery?
  10. How can I best prepare my child for pediatric urologic reconstruction surgery?

Reference

Authors: Davis MF, Srinivasan AK, Mittal S, Shukla AR. Journal: J Endourol. 2025 Mar;39(S1):S60-S65. doi: 10.1089/end.2024.0399. PMID: 40100836