Our ureters are delicate tubes that transport urine from the kidney to the bladder. If a narrowing develops here – for example directly at the transition from the kidney to the ureter (ureteropelvic junction obstruction, also called ureteropelvic stenosis or, in medical terms, pyeloureteral narrowing) or further along its course (ureteral stricture) – urine backs up. This often leads to flank pain, recurrent infections, and can over time damage the sensitive kidney tissue, up to and including loss of kidney function.
Our foremost goal at Urokompetenz – The Clinic for Urology in Düsseldorf: to restore unobstructed urine drainage and thereby secure the function of your kidney over the long term.
Causes and Diagnostics
A ureteropelvic junction obstruction is often congenital but may also only become apparent in adulthood due to crossing blood vessels. Ureteral strictures often arise from scarring (e.g., after kidney stones, previous operations, or inflammations).
To locate the narrowing precisely, we use modern imaging techniques (such as ultrasound, CT, or a renal function test/scintigraphy).
The Treatment: Robot-Assisted Pyeloplasty (da Vinci)
Treating such a narrowing requires surgical finesse of the highest order. Sometimes a temporary ureteral stent can help, but as a rule a surgical correction (the so-called pyeloplasty) is the safest way to remedy the problem permanently.
In this procedure, we remove the narrowed segment and suture the healthy ends of the renal pelvis and the ureter back together in a watertight fashion. For this highly complex reconstructive surgery, the da Vinci surgical system is the absolute gold standard worldwide.
Your Advantages of Robotic Surgery in Düsseldorf:
- Millimeter-precision work: The sutures we use are extremely fine. The 3D magnification and the tremor-free robotic instruments allow us to place millimeter-precise, absolutely watertight sutures.
- Gentle, with minimal pain: We operate through small incisions in the abdomen. Large flank incisions, as were customary in the past, are avoided entirely.
- Expertise at the highest level: Reconstructive urology requires maximum experience. Dr. Witt worked for 20 years as chief physician in Gronau and built up the largest center for robot-assisted surgery in Europe. With personal experience of over 12,000 robot-assisted operations and oversight of more than 25,000 robotic procedures, Dr. Witt is a world leader. We have the experience to deploy the precision of the surgical robot optimally in order to achieve a perfect functional outcome.
For Men and Women: Expertise on Equal Footing
Kidney and ureteral conditions affect women and men equally. Whether it concerns a congenital ureteropelvic junction obstruction or scarring after gynecological procedures: at our clinic, we treat you competently, on equal footing, and with a deep understanding of your individual life situation.
Rapid Second Opinion Before Reconstructive Procedures
Have you been diagnosed with a narrowing and been advised to have a stent (indwelling stent) placed or to undergo major surgery? Seek a medical second opinion. Modern robotic surgery often offers a considerably more elegant, permanent solution to free you from the tubes and the pain. We keep prompt appointments available for you for these consultations.