Professor Doron Schwartzhead of the nephrology and dialysis department
Kidney Treatment in Israel: Stenosis of the Renal Pelvis
Stenosis (blockage) of the renal pelvis is a congenital defect and one of the most common causes of hydronephrosis (enlargement of the renal pelvis due to impaired urine flow) in newborns and children, primarily in boys.
Kidney treatment in Israel is at the highest global level, with significant attention given to the diagnosis and treatment of kidney diseases in children.
In the pediatric urology department of the leading Israeli clinic Top Ichilov, experienced and world-renowned specialists, such as Dr. Yaakov Ben-Chaim, skillfully apply the latest methods of modern medicine and successfully perform surgical operations to eliminate renal pelvis stenosis.
Laparoscopic Pyeloplasty: Advantages of Treatment at Top Ichilov Clinic
The goal of the surgical intervention is to restore normal kidney function and free urine flow. The tried-and-true method for such operations is called “pyeloplasty.” The essence of the operation involves disconnecting the ureter from the renal pelvis, subsequently removing the section where the blockage occurs, and reconnecting the ureter. During the entire rehabilitation period after the operation, a stent is placed in the ureter or a nephrostomy (drainage of the kidney using a catheter) is performed. Until recently, pyeloplasty was performed using an open method, through an incision in the pelvic area. However, kidney treatment in Israel has advanced significantly, and in the last 5 years, pyeloplasty in the pediatric urology department of Top Ichilov has been performed laparoscopically, which requires considerable skill from the surgeon, as a large number of stitches must be placed when reconnecting the ureter. The laparoscopic method has several undeniable advantages:
- Painlessness during and after the operation
- Rapid rehabilitation
- Short hospitalization period
- Almost invisible scars from the operation
In the last two years, the pediatric urology department at Top Ichilov has been performing even more innovative laparoscopic pyeloplasty to deviate and fix the blood vessels crossing the kidney that create external pressure leading to renal pelvis stenosis. During this operation, the blood vessels are separated, and using a laparoscope, a wide and convenient transition from the pelvis to the ureter is identified, and the vessels are fixed in a higher position above this wide part to prevent blockage. This is an even more minimally invasive and shorter operation that does not require the use of stents.
Renal Pelvis Stenosis: Diagnosis at Top Ichilov Clinic
Renal pelvis stenosis is diagnosed in the embryo using ultrasound; however, only one in 1500 children with this stenosis requires surgery. In older children, renal pelvis stenosis may manifest as renal colic – abdominal and pelvic pain accompanied by nausea. Another symptom is hematuria (increased presence of blood in the urine), either spontaneous or caused by minor trauma.
The main cause of renal pelvis stenosis in young children is congenital internal blockage of the renal pelvis, while in older children, external blockage due to external pressure, for example, from a ligament of blood vessels deviating from their normal position crossing the kidney and supplying blood to the lower part of the kidney, is often the cause. Diagnosis, in this case, is also based on ultrasound findings of the urinary system, which can reveal hydronephrosis in combination with thin kidney parenchyma and an enlarged pelvis.
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