---
title: "Pyeloplasty — correcting impaired drainage of the kidney"
description: "Robot-assisted pyeloplasty for impaired urine drainage at the renal pelvis: causes, warning signs and the reconstructive operation."
source: "https://robotik-barbaraklinik.de/en/niere/nierenbeckenplastik/"
language: "en"
generated: "2026-11-05"
---

Kidney · Reconstructive urology

# Pyeloplasty for impaired urine drainage

When urine backs up in the kidney, it suffers silently. The narrowing can be corrected.

-   Problem

    Impaired drainage

    at the junction of renal pelvis and ureter

-   Goal

    Free drainage

    the narrowed segment is reconstructed

-   Access

    Robot-assisted

    reconstruction through a few small ports

The condition

Urine leaves the kidney through the renal pelvis and flows down the ureter into the bladder. If the junction between the two is narrowed — a so-called ureteropelvic junction (UPJ) obstruction — urine backs up into the kidney.

The narrowing can be congenital and cause symptoms only in adulthood. It can also develop later: through scar tissue, after inflammation, after previous procedures or through stones. Often a blood vessel crosses the ureter and compresses it — a so-called crossing vessel.

If the back-up persists, kidney function on that side slowly declines — often without any pain. That is the reason to treat impaired drainage even when symptoms are mild.

## How you may notice it

-   Recurring pain in the flank, often after drinking larger amounts

-   Repeated urinary tract infections or fever

-   Kidney stones

-   Blood in the urine

-   Nausea and vomiting during attacks of pain

-   A build-up of urine in the kidney that shows on imaging — sometimes without any symptoms at all

Second opinion

A congested kidney or recurring flank pain? Have the drainage assessed.

[+49 2381 681-1589](tel:+4923816811589) [Book an appointment online

*Bild: Doctolib*](https://www.doctolib.de/urologie/hamm/sami-ramzi-leyh-bannurah-731c5f05-a922-48c8-9188-ccff1f461f23) [Send an e-mail](mailto:urobotik@barbaraklinik.de) [More about the second opinion](https://robotik-barbaraklinik.de/en/zweitmeinung/)

## How it proceeds

1.  ### Before the operation

    The diagnosis rests on ultrasound and cross-sectional imaging; a split renal function study shows how much the affected kidney still contributes and how severely drainage is obstructed.

2.  ### The operation

    The narrowed segment is removed and the junction between renal pelvis and ureter is sutured anew, wide and free of tension. If a crossing vessel presses on the ureter and causes the narrowing, the connection is repositioned so that the vessel no longer compresses it. A thin ureteric stent is placed temporarily to support healing.

3.  ### After the operation

    The stent stays in place for some time and is then removed in a short procedure. Whether drainage remains free in the long term is checked afterwards with ultrasound and a renal function study.

## Why robot-assisted

Pyeloplasty is reconstruction, not removal. Its result depends on a fine, watertight, tension-free suture line in a spot that is hard to reach.

This is exactly where the robot-assisted technique plays to its strength: articulating instruments that follow the hand across several axes of movement, a three-dimensional magnified view and the filtering out of natural hand tremor. Compared with the open approach through a flank incision, the ports stay small.

*Bild: Surgeon in a sterile gown inserting the endoscope of the da Vinci system at the operating table.*

Reconstruction means suturing: tight angles, fine thread — that is what the articulating instrument tip is made for.

## How the repair works

The narrowed segment is removed and the junction rebuilt wide.

The narrowing dams up the urine. Dashed: what is removed.

Pelvis and ureter are sewn back together wide — over an internal stent.

Urine drains freely again. The stent is removed once healing is complete.

Schematic illustrations — not images of a patient.

Contact

## Having impaired kidney drainage assessed

Bring your ultrasound and cross-sectional images and any existing renal function study. We will put the findings in context together.

Consultation hours

-   Tuesday · 09:00–14:00
-   Thursday · 08:30–16:00

PD Dr. med. Sami-Ramzi Leyh-Bannurah. Appointments are arranged by the urology secretariat.

[Book an appointment online

*Bild: Doctolib*](https://www.doctolib.de/urologie/hamm/sami-ramzi-leyh-bannurah-731c5f05-a922-48c8-9188-ccff1f461f23) [Call us +49 2381 681-1589](tel:+4923816811589) [Send an e-mail urobotik@barbaraklinik.de](mailto:urobotik@barbaraklinik.de) [Request a callback We will call you back – in a time window that suits you.](https://robotik-barbaraklinik.de/en/kontakt/#rueckruf)