Ureteral Obstruction

Treatment Options

The goal of ureteral obstruction treatment is to remove blockages and repair damage to the ureters and kidneys. Because of the complexity of the urinary system, you may need more than one type of treatment.

Temporary treatment

A ureteral obstruction disorder causing severe pain may require an immediate procedure to remove urine from your body and temporarily relieve the problems caused by a blockage. The procedures may include:

• A catheter. Inserting a tube through the urethra into the bladder
• A ureteral stent. Inserting a hollow tube inside the ureter to keep it open
• Percutaneous nephrostomy. Inserting a tube through your back to drain the kidney directly

Minimally invasive (laparoscopic) surgery

Minimally invasive surgery is performed with a small, flexible tube (laparoscope) through which surgical instruments are inserted and manipulated. A tiny camera attached to the tube allows doctors to see inside the body.

• Endopyelotomy or laparoscopic pyeloplasty. These procedures are used to correct a blocked or damaged ureter. The surgeon reopens or repairs the ureter and inserts a stent to keep the ureter open. This stent will remain in place for up to six weeks and is removed during an office visit.

With minimally invasive surgery, patients often have shorter hospital stays, less discomfort and bleeding and a shorter recovery period.

Open surgery

Surgical procedures performed through an incision in the abdomen to correct a ureteral obstruction include:

• Heminephrectomy. This surgery removes the damaged part of the kidney caused by the ureteral obstruction.
• Ureterectomy. The surgeon removes all or part of a ureter then reconnects the kidney to the bladder by lowering the kidney and stretching the bladder up or replacing the ureter using other body tissue. The type of repair depends on how much of the ureter is removed.
• Ureteral reimplantation. The dysfunctional section of the ureter is removed and the remaining healthy sections are reconnected and reattached to the bladder.
• Transureteroureterostomy. The surgeon joins one ureter to the other resulting in sustained improvement in long-term renal function.

Medications

Ureteral obstructions may occur simultaneously with recurrent, difficult-to-cure urinary tract infections. Antibiotic treatment is necessary for each infection to prevent disease in the bladder or kidneys.