The principle of operation is that simple orthopedic surgery should be performed when the obstruction is light and the renal pelvis and calyx are seriously dilated; If the dilatation is obvious, the narrow segment of the lesion and the excessively dilated renal pelvis should be removed, and then anastomosis should be performed; In more serious cases, nephrectomy is performed. The success rate of operation varies from report to report, depending on the degree of dilatation of renal pelvis and calyx, the functional state of kidney, and whether the operation method is reasonable, generally between 80% and 90%.
The treatment of hydronephrosis should be more cautious, and the kidney should be preserved as much as possible. Generally, there are several situations: ① One side has serious water accumulation and the other side is light: the serious side can be treated first. In this way, there is no concern about renal insufficiency during the operation, and the safety of contralateral operation can be increased after the operation is successful. The indication of operation should be carefully judged on the lighter side, and its development can be closely observed if necessary. ② Serious hydrops on both sides: it can be treated by stages, but it is better to treat the heavier side first. ③ The hydronephrosis on both sides is light, so careful analysis should be made to determine the indication of operation.
If renal drainage is needed before the obstruction is relieved (such as severe infection or renal failure due to bilateral diseases), renal puncture can be performed and a renal drainage tube can be placed. At present, percutaneous drainage tube can replace nephrostomy open surgery.