✦ UPJ Obstruction Treatment

Open Pyeloplasty

Q: When is open pyeloplasty preferred over laparoscopic or robotic?

Open is preferred for complex redo cases, horseshoe kidney, dense adhesions from prior surgery, and when minimally invasive facilities are unavailable.

Q: How large is the scar after open pyeloplasty?

A flank incision of 8–12 cm is made; the scar fades significantly over 12 months and is usually hidden below the waistline.

Q: Is recovery longer than laparoscopic pyeloplasty?

Yes — hospital stay is 3–5 days vs 2–3 for laparoscopic; full recovery takes 4–6 weeks vs 2–3 weeks.

Open Surgical Repair of Ureteropelvic Junction Obstruction

90–150 min PROCEDURE

3–5 Days HOSPITAL STAY

>95% SUCCESS RATE

4–6 Weeks RECOVERY

What is Open Pyeloplasty?

Open Pyeloplasty using the Anderson-Hynes dismembered technique remains the standard against which all UPJ repairs are measured. Through a flank or posterior lumbotomy incision, the obstructed UPJ is excised, crossing vessels transposed, and a spatulated dependent anastomosis performed under direct vision. It is preferred for complex redo cases, horseshoe kidneys, very large redundant renal pelvis, or when minimally invasive facilities are unavailable. The procedure is performed under general or spinal anaesthesia with a hospital stay of 3–5 Days. Success rates reach >95% in appropriately selected patients at experienced centres.

Patients with complex or redo UPJ obstruction, horseshoe kidney, very young infants, or those requiring open surgery due to previous operations or unavailability of laparoscopic expertise. Patients must be adequately fit for anaesthesia and free from active systemic infection before proceeding.

How the Procedure Works

Incision & Access

Flank or posterior lumbotomy incision; Gerota's fascia opened.

UPJ Identification

UPJ and crossing lower-pole vessels identified under direct vision.

Obstructed Segment Excision

Obstructed UPJ segment excised; renal pelvis trimmed.

Anastomosis

Spatulated ureter anastomosed to dependent pelvis under direct vision.

Stent & Drain

DJ stent placed; drain inserted; wound closed in layers.

Outcomes

90–150 minDURATION

3–5 DaysHOSPITAL STAY

>95%SUCCESS RATE

4–6 WeeksFULL RECOVERY

Who Needs This Treatment?

→Direct tactile feedback and vision in complex redo cases.
→Equivalent success rate (>95%) to laparoscopic and robotic approaches.
→Suitable when minimally invasive surgery is unavailable or contraindicated.
→Allows complex pelvis reduction and intravascular crossing vessel management.
→Historical gold standard with extensive long-term outcome data.
→Preferred for horseshoe kidney and complex renal anomalies.

"Open pyeloplasty set the benchmark that all other UPJ repairs must meet. In skilled hands with direct vision, the anastomosis can be crafted to perfection — this is why results have never been surpassed."

— — Dr. Vipin Reddy, Consultant Urologist, Andrologist & Renal Transplant Surgeon

Common Questions

Frequently Asked

When is open pyeloplasty preferred over laparoscopic or robotic?+

How large is the scar after open pyeloplasty?+

Is recovery longer than laparoscopic pyeloplasty?+

Not sure which treatment is right for you?

Book a consultation with Dr. Vipin Reddy and get a personalised treatment plan.

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