Pyeloplasty is a type of reconstructive surgery that treats a condition called ureteropelvic junction (UPJ) obstruction which creates a blockage in the flow of urine and prevents reaching the bladder. In a healthy person, the urine travels from kidneys via ureters toward the bladder, and during urination, the muscles in the bladder force it to deplete the urine. However, if there is a blockage in one of the ureters (a tube that pushes the urine from kidneys to the bladder), the patient may experience debilitating conditions in discharging the urine and may face swollen of the kidney or damage to its functionality. Moreover, the ureteral pelvic junction (UPJ) is the area that links the kidney to the ureters, and the blockage occurs when a part of the kidney attaches to the ureter. Furthermore, if no treatment is advised, it will lead to kidney stones, infection, or kidney failure.

Ureteropelvic junction obstruction usually occurs in children, and in some cases, it may be present form birth during kidney formation. There are several reasons besides ureteropelvic junction obstruction that may create a blockage and the doctor based on the symptoms that the patient is showing chooses the right treatment. Some of these reasons are scar tissues, abnormality in blood vessels, or kidney stones.

In some instances, the detection of a blockage can be recognized before birth by using ultrasound, but it may be likely that even after the birth, no signs of blockage would be present. Therefore, some of the following tests will be recommended to determine the cause of the blockage:

• Urine and Blood test.
• CT urogram (an imaging exam that checks the kidneys, bladder, urinary tract, and ureters).
• X-ray imaging from kidneys, bladder, and ureters.

If a patient is suspected of having Ureteropelvic junction obstruction, several symptoms may be developed:

• Abnormal growth in the abdominal.
• Infection in the Urinary tract.
• Back pain.
• Kidney infection.

Pyeloplasty is performed under general anesthesia, and the whole duration takes about 3 to 4 hours. For a start, the doctor will make a small incision under the abdomen area. After that, a telescope along with other instruments will be inserted through the incision area to repair the blockage or cut extra tissue that has prevented the flow of the urine. Moreover, the healthy part of the kidney will be attached to the healthy part of the ureter, and a stent will be inserted into the kidney to drain urine.

Furthermore, some patients may need to perform a less invasive procedure for the removal of an obstruction in ureteropelvic junction. In this case, the doctor may use a Robotic Laparoscopic Pyeloplasty, which uses robotic assistance in the surgery.

Generally, the procedure is considered to be safe; however, there are some complications involved which will be explained below:

• Bleeding: During this procedure, the loss of blood is minimal, but in some cases, a blood transfusion may be required.  
• Infection: To decrease the chances of infection, all patients will be given antibiotics.
• Hernia: The occurrence of such a condition is rare, but it is possible.
• Tissue/organ injury: Injuries to the surrounding area like liver or bowel can occur.
• Follow up surgery to correct UPJ obstruction: Approximately 3%of patients may need additional surgery due to recurrent blockage.

Patients who have been traveled to Iran to continue their medication attested that Iranian surgeons and specialists are extremely competent in their specialized fields, and for every treatment which they advise, a rigorous examination will be conducted. Besides, the nursing staff in all of the specialized and sub-specialized hospitals in Iran are exemplary in terms of taking care of patients and offering the best medical services that significantly helps with the recovery. More importantly, ureteropelvic junction obstruction is quite prevalent, and about 5 in 100000 infants are impacted by this condition annually. For this reason, Iranian doctors have regarded this surgery as an effective treatment that requires no extra hospitalization, and less pain is involved. Therefore, following treatment for ureteropelvic junction obstruction in Iran would be a great choice considering the success rate that Iranian doctors have shown in recent years.