Dr. Lievano is a Urology doctor serving the DFW metroplex. His primary office location is at Baylor Scott & White in Fort Worth, Texas.
Dallas-Fort Worth urology surgeons can diagnose and treat a variety of kidney disorders, from kidney disease to stones. They’re well versed in robotic and laparoscopic surgery, which cut down on the recovery time and side effects associated with open surgery. If open surgery is necessary, however, you’re in good hands with these kidney surgeons.
Depending on your medical condition, you may require simple or complex surgery. Working with one of these physicians can help you recover and maintain a high quality of life.
Recommended Dallas-Fort Worth Kidney Doctors
Kidney surgery may be necessary for the following conditions:
- Chronic kidney disease
- Ureteropelvic junction obstruction
- Adrenal dysfunction
- Kidney failure
- Kidney disease or failure associated with diabetes
- Kidney stones
- Kidney donation
Chronic Kidney Disease
Diabetes often causes chronic kidney disease. Because the kidneys filter the blood, they can be damaged by blood that contains too much glucose. Patients with diabetes should be tested regularly for kidney function. If the kidneys become damaged or fail, a patient may need dialysis or kidney surgery.
Your nephrologist may use nonsurgical treatments for chronic kidney disease or dysfunction. A urologist is a specialist who is qualified to perform surgery to treat these conditions.
Ureteropelvic Junction Obstruction
Healthy kidneys filter the blood. They remove water, salts and other waste products, which are expressed as urine.
Before the urine makes it to the bladder, it must be carried from the kidneys via the renal pelvis and the ureter. The ureters connect to the kidneys at the renal pelvis. At least one functioning ureter must be available to transport the urine.
If the renal pelvis is blocked, urine can’t be transferred to the bladder as quickly as it is produced. As urine accumulates in the kidney, the organ swells.
This condition is often congenital, and doctors aren’t sure what causes it. It usually occurs in only one kidney. Doctors may notice it in an ultrasound when they see that one kidney is larger than the other.
Ureteropelvic junction (UPJ) obstruction can happen in adults who have kidney stones or have experienced swelling of the upper urinary tract. It can also occur after surgery.
Signs Of UPJ Obstruction
Most cases of UPJ obstruction are apparent in an ultrasound, and physicians may know well before an infant is born that the child has the condition. Some symptoms of UPJ obstruction include:
- Urinary tract infection
- Pain in the back or upper abdomen
- Blood in the urine
- Abdominal mass
- Poor growth
UPJ obstruction does not always cause pain. In many cases, the blockage comes and goes, allowing urine through from time to time. The condition can become painful if it leads to infection or the obstruction worsens.
Treatment For UPJ Obstruction
If infants have healthy kidneys, poor drainage may improve within a few months. In those cases, no treatment is necessary.
Surgery may be required when the obstruction doesn’t improve or gets worse. Pyeloplasty is the type of surgery that is indicated for UPJ obstruction. It involves removing the blockage and reattaching the ureter with a wide opening that allows for proper drainage.
A doctor may make an incision in the abdominal wall or insert a wire through the bladder to create an internal incision. Laparoscopic and robotic surgeries for this condition are associated with less pain and nausea.
Kidney tumors can interfere with the organs’ function. Whether they are malignant or benign, most tumors should be removed relatively quickly to allow the kidneys to work properly. The chances of surviving kidney cancer improve with surgery, according to the American Cancer Society.
Most people who have benign tumors or kidney cancer can have this type of surgery. It involves taking out the damaged part of the kidney while leaving the healthy tissue intact. Lymph nodes or other affected portions of the kidneys may be removed as well.
Partial nephrectomy can be performed to remove large or small tumors. The long-term outcomes are similar to those associated with complete kidney removal. However, a partial nephrectomy can help you maintain as much kidney function as possible.
This type of surgery may not be an option if the tumor is located in the center of the kidney. Patients with multiple tumors or extremely large growths may not be candidates for this surgery.
Radical nephrectomy involves removing the entire kidney and may be necessary when the condition cannot be treated with a partial nephrectomy. It may not be an option for larger tumors or those that have spread to lymph nodes or expanded into the renal vein.
The adrenal gland, lymph nodes, and surrounding fatty tissue may also be removed. Your body can function with one working kidney, and in many cases removing the cancerous organ can relieve other symptoms and improve survival rates.
When surgeons remove a kidney, they may make the incision in a few different places, including the center of the belly, below the ribs or in the back behind the kidney. The location of the incision is based on the size and position of the cancer.
Sometimes, tumors grow through important veins. If this is the case, the patient may be put on a cardiopulmonary bypass machine, which circulates the blood while the heart is stopped temporarily and the tumor is removed.
This type of surgery can be performed robotically or laparoscopically. Most doctors prefer these methods because they require smaller incisions, reduce recovery time and diminish the likelihood of complications.
The adrenals are small organs. One is located above each kidney. They release hormones that affect immunity, metabolism, stress levels, blood pressure and blood sugar levels. If one adrenal gland is removed, the other one takes over its function.
An adrenalectomy, or removal of the adrenal gland, may be necessary if the organ contains a tumor. This type of surgery is also indicated for adrenal glands that secrete certain hormones in excess.
During an adrenalectomy, the gland will be disconnected from the kidney and surrounding tissue. This can be done with open, laparoscopic or robotic surgery. You may need hormone therapy after the surgery if both adrenal glands are removed.