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Prof. Dr. Ali Avanoğlu
UPJ Obstruction • After surgery and follow-up

After Pyeloplasty: Hospital, Drains, Pain and Care at Home

The first days after pyeloplasty raise more questions for most families than the operation itself. This page walks through what happens in the hospital, what the drain and catheter are for, pain, feeding and wound care at home, and when you should call us right away.

Who this is forFamilies whose child has had pyeloplasty, or whose surgery date is approaching
Reading≈6 min
ByProf. Dr. Ali AvanoğluUpdated
This page is part of UPJ obstruction.Read the full treatment overview on the hub page
KIDNEY END (COILED)sits in the pelvis, does not slipBLADDER END (COILED)floats free in the bladder4–6 WEEKSremoved afterward by cystoscopyCAN BE NORMALfrequent urinationmild blood in urinemild flank pain when voidingplenty of fluids · regular voidingJJ (DOUBLE-J) STENT · CARE
JJ stent: kidney end in the pelvis, bladder end in the bladder, 4–6 weeks; symptoms that can be normal
01 · The first hours after surgery, and the hospital stay02 · Drain, catheter and stent: what each one does03 · The first two weeks at home: pain, the wound, bathing and feeding04 · When you should see a doctor right away05 · Stent removal and the first check-up: what comes next
In brief5 madde
  • The first hours after surgery, and the hospital stay: Once pyeloplasty (repair of UPJ obstruction, i.e.
  • Drain, catheter and stent: what each one does: After surgery your child may have a few temporary tubes; all of them serve the same purpose — letting the newly rejoined junction heal without trouble.
  • The first two weeks at home: pain, the wound, bathing and feeding: Once you're home, the most common questions are about pain, wound care and bathing.
  • When you should see a doctor right away: Problems after pyeloplasty are rare, but simple to fix when caught early.
  • Stent removal and the first check-up: what comes next: Discharge isn't the end of the care — it's the start of follow-up.
01

The first hours after surgery, and the hospital stay

Once pyeloplasty (repair of UPJ obstruction, i.e. ureteropelvic junction obstruction) is finished, your child is first watched in the recovery room, then moved to the ward. Drowsiness, mild nausea and a dry throat in the first hours come from the anesthesia and usually resolve on their own.

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  • How long the hospital stay lasts depends on the approach and age. Open pyeloplasty is generally followed by a stay of a few days; laparoscopic or robotic pyeloplasty is generally followed by a shorter stay; in infants, feeding needs to settle into a routine first. We'll agree on the exact length with you before discharge, based on your child's condition.
  • Pain control is planned in advance: regular pain medicine is given in the first days, aiming to keep your child breathing and moving comfortably. If pain increases, just tell the nurse — don't wait; the pain-medicine schedule is adjusted to the child. The medicine name and dose will be written on your discharge paperwork.
02

Drain, catheter and stent: what each one does

After surgery your child may have a few temporary tubes; all of them serve the same purpose — letting the newly rejoined junction heal without trouble. Which ones are placed depends on the surgeon's preference and your child's condition.

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  • The drain is a thin tube that removes any urine or fluid that may collect at the surgical site; it's usually removed on the ward once the amount draining decreases, in the first days. The urinary catheter keeps the bladder empty, reducing back-pressure on the new repair, and is usually removed on the first day or within the first few days. The JJ (double-J) stent, on the other hand, is a thin tube placed between the kidney and the bladder that isn't visible from outside; it stays in for several weeks and is removed in a separate, short procedure.
  • At some centers, a tube that exits through the skin (an externalized stent or nephrostent) is used instead of an internal stent; this is usually removed in the outpatient clinic within a week or two, without anesthesia. We'll tell you in writing at discharge which drainage method was chosen and when it will be removed.
03

The first two weeks at home: pain, the wound, bathing and feeding

Once you're home, the most common questions are about pain, wound care and bathing. Most children return to their daily routine within a few days; pain should ease a little more each day — it shouldn't increase.

  • Give pain medicine at the times written on the paperwork; call us if pain increases or isn't relieved.
  • Keep the wound dressing on for the stated period, and check for redness or discharge.
  • Give plenty of fluids, prevent constipation, and watch the color of the urine.
  • Return to school or nursery is usually within one to two weeks; physical education and contact sports come later.
  • Mark the follow-up appointment and stent-removal date on your calendar.
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  • The wound is usually closed with dissolvable stitches and covered with a waterproof dressing. Keep the dressing on for as long as your doctor advised; pat it dry if it gets wet. Showering is usually allowed after a few days; baths, pools, or anything that soaks the wound are postponed until it's fully healed.
  • Feeding continues as normal; plenty of fluids increase urine flow and, if a stent is in place, ease discomfort. Constipation can cause straining and pain, so pay attention to fiber and fluid intake. Strenuous sports, cycling, and games with a risk of impact to the abdomen are postponed for the first weeks; walking and calm play are fine.
04

When you should see a doctor right away

Problems after pyeloplasty are rare, but simple to fix when caught early. If any of the following occurs, contact us the same day without waiting for your appointment, or go to the nearest emergency department; our WhatsApp line is open for these questions.

  • Fever (38 °C/100.4 °F and above), especially with flank pain or shivering: possible obstructed or infected kidney.
  • Increasing pain, vomiting, or a swollen or tense abdomen in the first weeks after surgery.
  • Discharge from the wound, widespread redness, or urine leaking through the wound.
  • With a stent or nephrostomy in place: fever, severe pain, dark bloody urine, or the nephrostomy drainage stopping.
  • In a child with a solitary kidney or bilateral hydronephrosis: reduced urine output, swelling around the eyes or legs, marked weakness.
  • In an infant: not feeding, excessive sleepiness, visible blood in the urine.
05

Stent removal and the first check-up: what comes next

Discharge isn't the end of the care — it's the start of follow-up. The first check-up is usually a few weeks after surgery; if a stent is in place, this visit confirms the removal date.

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  • A JJ stent typically stays in place for 4–6 weeks (2–8 weeks depending on the center) before being removed under brief anesthesia via cystoscopy; this is a same-day procedure and most children go home the same day. The first ultrasound is usually planned around 3 months after surgery; the hydronephrosis (kidney swelling) is not expected to disappear right away — a slow improvement is normal.
  • Being followed by the same two pediatric urology specialists from diagnosis through follow-up means even small post-operative questions get a quick answer. The full follow-up schedule and what the ultrasound shows is covered separately.
UPJ Obstruction video guide3 short videos, in order
Frequently asked questions
How many days does the hospital stay last after pyeloplasty?
It varies with the approach, age and how quickly your child recovers. Open pyeloplasty is generally followed by a stay of a few days; laparoscopic and robotic pyeloplasty is generally followed by a shorter stay. Discharge is planned once feeding is on track, pain is controlled with oral medicine, and the drain has been removed.
Is it normal to see blood in the urine after surgery?
Mild pink-to-red urine is common in the first days and while a stent is in place, and usually clears with plenty of fluids. If the urine is dark red or has clots, if your child can't pass urine, or if fever is present, call us without waiting.
When can my child return to school and sports?
Most children return to school within one to two weeks; infants get back to their usual routine within a few days. Physical education, cycling and contact sports are postponed until the wound has healed and the stent is out; we'll agree on the exact timing at the follow-up visit.
Does my child need antibiotics?
This decision is made based on your child and whether a stent is in place; some centers use prophylactic antibiotics for as long as the stent stays in, others don't. If your doctor prescribed a medicine, you'll find the dose and duration on the discharge paperwork; don't stop or extend it on your own.
Next • After surgery and follow-upJJ (Double-J) Stent→
Related pagesFull index →
After surgery and follow-upJJ (Double-J) StentA JJ (double-J) stent is a temporary, thin tube placed between the kidney and bladder after pyeloplasty; it keeps the newly rejoined junction open while it heals. How long it stays in a child, which symptoms are normal, and how it's removed are among the questions families ask most.After surgery and follow-upFollow-Up After PyeloplastyFollow-up after pyeloplasty answers more than just "has the hydronephrosis gone away?" Ultrasound tracks the widening's course, and MAG3 tracks function and drainage when needed; a slow improvement in kidney swelling is expected, and success is defined by the overall course, not a single measurement.After surgery and follow-upPyeloplasty ComplicationsPyeloplasty is a safe, high-success operation, but like any surgery it carries possible risks. On this page we explain, in plain language, complications such as urine leak, infection, stent problems, bleeding and recurrent narrowing — how often they occur, and which symptoms mean you should see a doctor right away.Pyeloplasty and approachesWhat Is Pyeloplasty? The UPJ Obstruction Surgery, Step by StepPyeloplasty is the operation that repairs the narrow junction (UPJ) between the renal pelvis and the ureter. This page explains why the operation is done, the steps from preparation to discharge, and the question families ask most: "how many surgeries are needed."
UPJ Obstruction topic clustersMain treatment page →
Basics 7Diagnosis and evaluation 6Follow-up or surgery? 7Conservative follow-up 5Pyeloplasty and approaches 7After surgery and follow-up 6By age, and special situations 7
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