Concierge urology · UK
Laparoscopic and robotic pyeloplasty in the UK, by a consultant urologist.
A proper Anderson-Hynes reconstruction for PUJ obstruction — laparoscopic or robotic — by a named BAUS consultant urologist, in a theatre that does these cases weekly.
Why patients choose us
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A consultant urologist, in theatre
Not a training list. A named consultant who does pyeloplasty regularly — laparoscopic or robotic — in a proper theatre with a full surgical team.
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Robotic option on the table
Increasingly the UK default for PUJ reconstruction. We say when a da Vinci case is worth the extra cost, and when a laparoscopic approach is just as good.
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Independent, and free
We are paid by no clinic, so the recommendation is impartial and costs you nothing.
Indicative pricing
What a private pyeloplasty costs in the UK.
Indicative ranges across our partner clinics. Send the details and we quote firm figures across two or three options — including whether robotic is worth the uplift for your case.
In short
A laparoscopic pyeloplasty in our network: £8,000–£14,000, home in one to two nights.
| Procedure | Indicative range | Typical duration | Recovery |
|---|---|---|---|
| Laparoscopic pyeloplasty (private) | £8,000–£14,000 | 90–180 min | 1–2 nights |
| Robotic (da Vinci) pyeloplasty (private) | £12,000–£18,000 | 120–180 min | 1–2 nights |
| MAG3 renogram with furosemide | £450–£900 | 60 min | 3–5 days |
| CT urogram | £600–£1,200 | 30 min | 2–3 days |
| JJ stent removal (flexible cystoscopy) | £600–£1,200 | 15 min LA | Same visit |
| Consultant urology opinion | £250–£450 | 30–45 min | Same visit |
Prices vary by clinic, by which urologist does the case, by whether robotic (da Vinci) is used, and by hospital stay length. NHS pyeloplasty via a BAUS-registered urologist is free at the point of care but waits are usually several months. We come back with a firm quote within one working day.
The problem
The right surgeon, the right approach, at the right moment.
PUJ obstruction is one of those diagnoses that sits in a scan report for years before anyone acts on it. The trick is deciding when to reconstruct — and by whom.
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Not sure it is needed?
Not every dilated kidney needs surgery. A MAG3 renogram tells you whether it is genuinely obstructed. We say so before you agree to an operation.
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Laparoscopic or robotic?
Both work — the answer depends on your anatomy, the surgeon, and what you are willing to pay. We give you the honest comparison.
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Want it done properly?
A named consultant urologist with a reconstructive interest, a proper theatre, and a follow-up MAG3 booked before you leave hospital.
The journey
From enquiry to stent removal — what happens, in order.
One consultant from first message to the follow-up MAG3 — including the stent-removal cystoscopy at four to six weeks.
Phase 1 · Before your procedure
Concierge, off-stage for you
Phase 2 · On the day
One to two nights on the ward
Phase 3 · After
Concierge, back on
- 01
Before
You tell us what is going on
A short, confidential form. Flank pain, hydronephrosis on a scan, prior stones or UTIs, and any MAG3 or CT results you already have.
- 02
Before
We come back with a recommendation
Within one working day: whether pyeloplasty is the right step, laparoscopic vs robotic, an indicative price, and which urologist fits your case.
- 03
Before
We arrange the workup
MAG3 renogram with furosemide, up-to-date imaging and pre-operative bloods. Any blood-thinning medication is reviewed with the team.
- 04
On the day
Admission and anaesthetic
Admission on the morning of surgery. Consent, marking, and a general anaesthetic with the consultant anaesthetist.
- 05
On the day
The procedure itself
90 to 180 minutes. Three to four small ports, dismembered pyeloplasty (Anderson-Hynes), tension-free reanastomosis over a JJ stent.
- 06
On the day
Overnight stay
One to two nights on the ward. Catheter out the next morning in most cases, and home once eating, drinking and mobile.
- 07
After
Stent removal and review
JJ stent out at four to six weeks under a short cystoscopy. MAG3 at three to six months to confirm drainage. Back to sport at six weeks.
Typical end-to-end: 3–4 weeks from enquiry to procedure. JJ stent out at 4–6 weeks. Follow-up MAG3 at 3–6 months.
When it helps
When pyeloplasty is the right step.
The situations that lead to a laparoscopic or robotic pyeloplasty, plus the one red flag that means an emergency rather than an appointment.
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Congenital PUJ obstruction
A narrowing at the pelviureteric junction present since birth — often picked up in adulthood on a scan for pain or stones.
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Crossing lower-pole vessel
An accessory artery draping over the PUJ, kinking drainage from the kidney. Transposed and repaired at the same operation.
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Acquired PUJ stricture
Scarring from previous stones, prior surgery or infection that has narrowed the junction and blocked drainage.
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High ureteric insertion
The ureter joins the pelvis too high, so urine pools rather than drains. Dismembered pyeloplasty relocates the join.
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Recurrent stones or UTIs
A kidney that keeps forming stones or hosting infections because it is not draining — pyeloplasty fixes the underlying obstruction.
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Deteriorating split function on MAG3
Serial renograms showing the affected kidney losing function — a clear indication to reconstruct rather than watch.
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Symptomatic hydronephrosis
A dilated renal pelvis causing flank pain, especially after fluids or alcohol (Dietl’s crisis) — pyeloplasty relieves both.
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Red flag: pyonephrosis or sepsis
A blocked, infected kidney with fever or rising inflammatory markers is an emergency — same-day A&E for drainage first, then reconstruction later.
Procedure options
More than one way to reconstruct a PUJ.
What each option on the table actually involves — and which fits which anatomy.
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Laparoscopic dismembered pyeloplasty
The Anderson-Hynes standard. The narrow PUJ segment is excised, the ureter spatulated, and a tension-free join made over a JJ stent.
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Robotic (da Vinci) pyeloplasty
Increasingly the UK default. Wristed instruments make the fine suturing easier — often shorter learning curve and slightly quicker recovery.
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Transperitoneal approach
Access through the abdominal cavity — the commonest laparoscopic route, with excellent views of the kidney and any crossing vessel.
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Retroperitoneal approach
Access behind the peritoneum — avoids the bowel and useful in patients with prior abdominal surgery. Working space is tighter.
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Crossing vessel transposition
If a lower-pole artery is compressing the PUJ, it is moved behind the reconstructed join at the same operation.
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Endopyelotomy (alternative)
An endoscopic cut through the narrowed PUJ. Less invasive, but success rates are lower (60–70%) — reserved for selected cases.
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Open pyeloplasty (historic)
The traditional flank incision. Almost entirely replaced by laparoscopic and robotic approaches in UK practice.
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Consultation only
An honest discussion of whether reconstruction is needed at all, and which approach fits — no obligation.
Our vetted UK network
A small panel of reconstructive urologists, we picked them.
BAUS consultant urologists across London and the major private centres, with a subspecialty interest in upper-tract reconstruction. Not listed publicly — introductions are made privately, once we understand your case.
Selection criteria
How we choose every urologist in our network.
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Consultant urologists with a reconstructive or robotic subspecialty interest
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BAUS-registered, with audited pyeloplasty outcomes
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Robotic (da Vinci) access where indicated
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On-site interventional radiology for percutaneous drainage if needed
Safety and recovery
What to expect afterwards — honestly.
Laparoscopic and robotic pyeloplasty are safe operations with a very high success rate in experienced hands. The things worth planning are the JJ stent window, the return-to-sport timeline, and knowing what is normal after.
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Success rates above 90% at five years
Well-selected laparoscopic and robotic pyeloplasty in UK series relieves obstruction in more than nine out of ten patients — comparable to open surgery, with a much easier recovery.
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Urine leak in around 5%
A small leak from the anastomosis is the commonest early complication. Usually settles with the JJ stent in situ; occasionally needs a drain or a longer stent.
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Anastomotic stricture (5–10%)
Scarring at the new join can narrow it over months. Picked up on a MAG3 renogram — treated by endopyelotomy or, rarely, a redo pyeloplasty.
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Bleeding is uncommon
Blood loss is usually minimal. Transfusion is rare. A crossing vessel is transposed carefully to avoid injury.
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Stent-related pain and UTIs
The JJ stent is the least fun bit — expect some flank ache when passing urine and a small risk of a urinary infection while it is in place.
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One to two nights in hospital
Most patients go home the day after surgery. Catheter usually out the following morning; the JJ stent stays for four to six weeks.
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Back to office at two to four weeks
Desk-based work in two to four weeks. Gym at four weeks, contact sport and heavy lifting at six weeks. Driving when you can do an emergency stop pain-free.
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DVT prevention as standard
Compression stockings and low-molecular-weight heparin during your stay. Get up and walking the same day as surgery.
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Red flags
Fever, spreading redness, heavy bleeding, or a sudden severe flank pain after discharge are not normal — call the clinic or A&E the same day.
Reading your operation note
Your operation note in four parts. Read the last one first.
Whether the case was done laparoscopically or robotically, the note the urologist sends you keeps to the same shape.
A quiet reminder
Surgical language is precise and can read coldly — we translate it for you.
If you would like us to talk you through the note before your review, just ask.
- 01 Header
Indication and approach chosen
Why the procedure was done — congenital PUJ obstruction, crossing vessel, acquired stricture — and whether laparoscopic or robotic was used.
- 02 Technique
Anaesthetic and surgical technique
Number and position of ports, transperitoneal or retroperitoneal, spatulation, suture material, and any crossing vessel transposition.
- 03 Findings
PUJ segment, stent and drainage
The length of PUJ excised, the position of the JJ stent, whether a drain was left, and any intra-operative findings.
- 04 Impression
Recovery, stent removal, MAG3 follow-up
Read this first: expected recovery, when the JJ stent comes out, and when the follow-up MAG3 renogram is booked.
Recognised by major UK insurers
Pyeloplasty is generally covered by UK private medical insurance when medically indicated. Robotic uplifts may or may not be reimbursed. We confirm cover with your insurer before booking.
Frequently asked
Everything we get asked about laparoscopic pyeloplasty.
Quick answers on when it is really needed, laparoscopic vs robotic, cost, recovery and risks.
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What is a laparoscopic pyeloplasty?
A minimally invasive reconstruction of the pelviureteric junction (PUJ) — the narrow bit where the kidney joins the ureter. The blocked segment is excised and a wider, tension-free join is made over a JJ stent. Done through three or four small ports rather than a flank incision.
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Laparoscopic or robotic — which is better?
Both work. Robotic (da Vinci) is increasingly the UK default because wristed instruments make the fine suturing easier and the learning curve is shorter. Outcomes at expert hands are similar. Cost is the practical difference: robotic runs £4,000–£6,000 more privately.
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When is pyeloplasty actually needed?
When there is symptomatic PUJ obstruction (flank pain, especially after fluids), a split function below 40% on MAG3, deteriorating function on serial renograms, recurrent stones or infections in the affected kidney, or an accessory vessel proven to be causing obstruction.
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How much does private pyeloplasty cost in the UK?
Roughly £8,000–£14,000 for laparoscopic and £12,000–£18,000 for robotic (da Vinci) in London and the major private centres. NHS pyeloplasty via a BAUS-registered urologist is free at the point of care but waits can be several months.
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How long does recovery take?
One to two nights in hospital. Back to office work in two to four weeks, gym at four weeks, contact sport and heavy lifting at six weeks. The JJ stent stays in for four to six weeks and can cause some flank ache when passing urine.
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What are the risks?
Urine leak from the join in around 5%, anastomotic stricture in 5–10% over the following year, bleeding (uncommon), stent-related pain and UTI while the JJ is in place, DVT (prevention is routine), and the small chance of restenosis needing endopyelotomy or a redo.
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Is endopyelotomy a real alternative?
For a short, well-selected stricture — sometimes. Success is 60–70% versus 90%+ for pyeloplasty, so it is usually reserved for short recurrences or patients who cannot have a reconstruction. Open pyeloplasty is historic; almost no UK urologist does it as first choice now.
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How do you confirm the diagnosis before surgery?
Ultrasound to show hydronephrosis, a MAG3 renogram with furosemide to prove obstruction and measure split function, and a CT urogram to map the anatomy — in particular, to look for a crossing vessel that will change the operation.
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