Kidney & Ureter Conditions

Conditions treated by Dr Basto

A pelvi-ureteric junction obstruction (PUJO) occurs when there is a blockage at the junction where the kidney meets the ureter, impairing the flow of urine. This condition can lead to internal kidney swelling (hydronephrosis), pain, recurrent infections and potential loss of kidney function if left untreated. Assessment frequently includes imaging tests and endoscopy to assess the urinary tract with a camera.  Surgical options, including minimally invasive pyeloplasty, are effective in restoring normal urinary drainage.

Ureteric strictures are narrowings of the ureter that can obstruct urine flow causing pain, infections, and kidney damage. These strictures may develop from prior surgeries, trauma or infections. Treatments include endoscopic procedures or reconstructive surgery, such as ureteric reimplantation, to restore urine flow.  The type of surgery will vary depending on the location and length of the stricture, as well as a range of other patient factors. These procedures can be performed by minimally invasive techniques such as laparoscopy or robotic assisted surgeries.

Urinary diversion involves creating alternative pathways for urine drainage when the normal flow through the bladder is impaired or no longer possible. Less invasive methods include intermittent catheterisation, where a catheter is periodically inserted and removed to empty the bladder, or alternatively indwelling catheters which remain in place for ongoing drainage (E.g Urethral or suprapubic). Perineal urethrostomy is another option used in complex urethral conditions, allowing direct drainage from the urethra through a perineal opening.

Where the obstruction is above the bladder level, for example in the ureter, ureteric stents can be placed to keep the ureters open or nephrostomies can drain urine directly from the kidney via an external tube.

In cases requiring more permanent solutions, surgical options like the ileal conduit are employed. This involves redirecting urine through a segment of the intestine to a stoma on the abdominal wall, providing a reliable long-term diversion. These approaches are tailored based on individual conditions and goals for quality of life.

Kidney cancer typically arises from the lining of the kidney’s tubules. Early stages may show no symptoms and are frequently detected incidentally on imaging, advanced cases can cause blood in the urine or flank pain.

As a reconstructive and functional urologist, Dr Basto specialises in restoring anatomy and function of the urinary tract.  She cares for early stages of kidney cancer. For more advanced stages of kidney cancer, she works closely with trusted uro-oncology colleagues who have specialised expertise in these areas. This collaborative approach ensures that patients receive the highest standard of care tailored to their individual needs, whether in the early or advanced stages of cancer.