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PUJ obstruction is a narrowing where the kidney joins the ureter. Urine backs up, the kidney swells (hydronephrosis) and, if left alone, slowly loses function. Dr. Kumar Rajesh Ranjan, M.Ch (Urology), fixes it with laparoscopic pyeloplasty — keyhole reconstruction that removes the narrow part and rejoins the kidney to the ureter.
Laparoscopic pyeloplasty is keyhole surgery to treat pelviureteric junction (PUJ or UPJ) obstruction — a blockage where the kidney's collecting system (renal pelvis) joins the ureter. Through 3-4 small cuts, the surgeon removes the narrowed segment, trims the swollen pelvis and stitches it back to the ureter over a temporary DJ stent. It is the standard treatment for symptomatic PUJ obstruction or a kidney that is losing function, with high long-term success. In Patna it is performed by M.Ch urologist Dr. Kumar Rajesh Ranjan at Satyadev Super Speciality Hospital.
The pelviureteric junction (PUJ) is where the funnel-shaped renal pelvis drains into the ureter. If this point is narrow, kinked or crossed by a blood vessel, urine cannot drain freely and the kidney balloons — this is hydronephrosis.
Many cases are found before birth on pregnancy scans; others show up in teenagers or adults as side pain after drinking a lot of fluid, infections or kidney stones. Not every swollen kidney needs surgery — a renal scan shows whether the kidney is actually blocked and losing function.
In children, Dr. Ranjan plans surgery with child-sized instruments and close follow-up; see our paediatric urology page.
Some people have no symptoms; the blockage is found on a scan.
Often worse after drinking a lot of water, tea or alcohol.
Episodes of pain and vomiting, especially in children.
Infection in stagnant urine, sometimes with high fever.
⚠ Needs evaluationPoor drainage helps stones form in the kidney.
Especially after minor injury to a swollen kidney.
Antenatal hydronephrosis needs follow-up scans after birth.
Laparoscopic pyeloplasty offers the success of open surgery with a much easier recovery.
| Feature | Laparoscopic Pyeloplasty | Open Pyeloplasty | Endopyelotomy (Endoscopic) |
|---|---|---|---|
| Cuts | 3-4 small keyhole cuts | One larger cut | None |
| Long-term success | High | High | Lower |
| Crossing vessel | Can be dealt with | Can be dealt with | Not addressed |
| Pain after surgery | Less | More | Least |
| Hospital stay | 2-4 days | 4-6 days | 1-2 days |
Step by step, from tests to going home.
Ultrasound, CT urography and a DTPA/EC renal scan show the blockage and how well the kidney works.
Before surgeryYou are fully asleep throughout.
15 minutesThree or four 5-10 mm ports are placed and the kidney is reached with an HD camera.
First 30 minutesThe narrow segment is removed, any crossing vessel is moved aside, and the pelvis is stitched to the ureter over a DJ stent.
1.5-2.5 hoursDrain and catheter removed in 1-3 days; most go home in 2-4 days.
2-4 days
Keyhole surgery means less pain and a faster return to normal life.
Walking the next day; drain and catheter removed early.
Home; light activity and plenty of fluids.
Back to school or desk work.
DJ stent removed in a short day procedure.
Ultrasound and renal scan confirm good drainage.
Results in urology depend on the surgeon's training and the equipment available. Here is what you get at Satyadev Urology.
MBBS, MS, M.Ch (Urology), FMAS, with fellowship training in advanced laparoscopic urology and kidney transplant at Urocare, Kochi and Aesculap Academy, Germany.
Holmium laser, flexible ureteroscopes, C-arm fluoroscopy, HD laparoscopy and modular operation theatres in one hospital.
Recipient of the Stars of Bihar Award, the Acharya Charak Medical Award and Icon of Health, Bihar.
Round-the-clock critical care and anaesthesia support for high-risk and emergency patients.
Cashless treatment for eligible patients under Ayushman Bharat PMJAY and most major insurers and TPAs.
Consultation, CT and ultrasound, lab tests, surgery and follow-up under one roof — no need to travel to Delhi or Vellore.
11:00 AM – 3:00 PM, Monday to Saturday. Consultation ₹800, valid for 15 days.
3:00 PM – 4:00 PM, Monday to Saturday. Sunday OPD closed; emergency open 24×7.
Old prescriptions, scan and blood reports, and a list of your current medicines, especially blood thinners.
Read the full profile of Dr. Kumar Rajesh Ranjan, urologist in Patna, his doctor profile at Satyadev Hospital, or the hospital OPD timings.
Urology care for babies and children.
Keyhole kidney removal for cancer or a non-working kidney.
All options for kidney stones: RIRS, PCNL, URSL and medicines.
Laser removal of stones stuck in the ureter.
Lasting repair of urethral stricture.
Transplant surgery including laparoscopic donor nephrectomy.
"One of the best doctors for kidney problems in Patna. All advanced procedures like PCNL, URS, laparoscopic nephrectomy done here. Clean and hygienic."
Rajan Sharma"Dr. Kumar Rajesh Ranjan ne clearly samjhaya ki darne ki koi baat nahi hai aur treatment possible hai. Mera operation yahan successfully hua. Ayushman Bharat card se treatment ho gaya."
Ajit Thakur"Bahut bahut dhanyawad sir. Kisi bhi tarah ki dikkat nahi hui. Yahan mera bacche ka ilaj bahut hi bdhiya dhang se hua hai."
Rupesh PaswanAnswered by the urology team at Satyadev Hospital, Patna.
Dr. Kumar Rajesh Ranjan, M.Ch (Urology), FMAS, performs laparoscopic pyeloplasty for adults and children at Satyadev Super Speciality Hospital, Patna. He has trained in advanced laparoscopic urology at Urocare, Kochi and Aesculap Academy, Germany.
No. Many mild cases, especially in babies, improve on their own. Surgery is advised when a renal scan shows true blockage, falling kidney function, pain, infections or stones.
Laparoscopic pyeloplasty has high long-term success, similar to open surgery, in experienced hands. Success is confirmed with a renal scan a few months after surgery.
Usually 2-4 days. Most people return to school or desk work in 2-3 weeks.
A DJ stent protects the new join while it heals. It is removed after about 4-6 weeks in a short day procedure.
Yes, for eligible patients at Satyadev Super Speciality Hospital, along with CGHS, ESIC and most insurance TPAs.
अगर जांच में किडनी की नली (PUJ) में रुकावट और किडनी की कार्यक्षमता घटती दिखे, तो लैप्रोस्कोपिक पाइलोप्लास्टी से दूरबीन द्वारा रुकावट ठीक की जाती है। हल्के मामलों में केवल निगरानी काफी होती है।
आमतौर पर 2-4 दिन। 4-6 हफ्ते बाद स्टेंट निकाल दिया जाता है।
Call +91-8050295197 or +91-8235152796, or use the contact page. Bring your ultrasound, CT and renal scan reports.
Keyhole repair of PUJ obstruction for adults and children, by an M.Ch urologist. Call now or visit us at Magistrate Colony, Khajpura, Patna.
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