The surgeon will determine the exact plastic procedure at the operating table. Certain precautions will help insure good results:
1. Approach the renal pelvis through the lateral margin of Gerota's fascia rather than as far posteriorly as is customary. This provides a fatty pad behind and in front of the ureter to prevent fibrous adhesion to the posterior muscles.
2. Use nephrostomy (or pyelostomy) tubes and splints only when absolutely necessary, because they are irritating and introduce infection.
3. Use fine chromic sutures for reapproximation of pelvic and ureteral edges. Do not grasp edges with forceps.
4. Drain the area of repair accurately.
HINMAN F. Techniques for Ureteropyeloplasty. AMA Arch Surg. 1955;71(5):790-794. doi:10.1001/archsurg.1955.01270170148027