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Pediatric Hynes-Anderson Pyeloplasty

Hynes-Anderson dismembered pyeloplasty is the gold standard surgery for ureteropelvic junction obstruction (UPJO) in children, with a 90-95% success rate.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Üroloji department. Book Appointment →

What is Pediatric Hynes-Anderson Pyeloplasty?

Hynes-Anderson pyeloplasty is the gold standard surgery for ureteropelvic junction obstruction (UPJO) in children. Defined by Anderson and Hynes in 1949; has now been adapted to laparoscopic and robotic techniques. UPJO is the most common congenital pediatric upper urinary tract obstruction (1/1500).

Indications: symptomatic UPJO (pain, infection, hematuria), decreased differential renal function (DRF <40%), progressive hydronephrosis, T1/2 >20 min on diuretic renogram, recurrent UTI. Non-surgical follow-up criteria: asymptomatic, DRF >40%, stable hydronephrosis.

Surgical technique: dorsal lumbotomy or anterior subcostal incision (open) → renal pelvis exposure → narrowed UP segment excision → renal pelvis reduction → ureter spatulation → 5-0/6-0 absorbable suture watertight anastomosis → DJ stent placement (4-6 weeks). Laparoscopic/robotic: same technique, 4 ports, 90-95% success. Postop: stent removal (6 weeks) → renogram (3 months).

Symptoms

Antenatal hydronephrosis (US, most common detection)
Postnatal palpable mass
Recurrent UTI
Flank pain (older children, Dietl crisis)
Hematuria (especially after trauma)
Failure to thrive (bilateral)

Risk Factors

Male gender (2:1)
Left side dominance
Aberrant lower pole vessel (10-15%)
VATER/VACTERL association
Prune belly syndrome
Antenatal hydronephrosis history

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Antenatal hydronephrosis (postnatal US 1 week)
  • Recurrent UTI in newborn
  • Palpable mass, irritability
  • Flank pain in older child
  • Hematuria after trauma
  • Failure to thrive (bilateral case)

Treatment Methods

01
Diagnosis: postnatal US (1 week + 4-6 weeks) + MAG3 renogram
02
Surgical decision: DRF <40%, T1/2 >20 min, symptomatic
03
Hynes-Anderson dismembered pyeloplasty (gold standard)
04
Laparoscopic/robotic-assisted (older children)
05
DJ stent (4-6 weeks)
06
Postop renogram (3-6 months)

Which Department to Visit?

You can visit our Üroloji department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.