Redo Pyeloplasty in Children: When the First Repair Fails

Failed pyeloplasty is uncommon, but when it happens, the decision-making becomes more complex than simply repeating the operation.In this episode, we discuss how to distinguish persistent hydronephrosis from true failure, when worsening ultrasound or symptoms should trigger re-evaluation, and why definitive reconstruction often outperforms temporizing treatments.The central idea: failed pyeloplasty is not just a failed anastomosis. It is a diagnostic and surgical problem that requires proof, patience, and then decisive reconstruction.Keywords: UPJO, redo pyeloplasty, failed pyeloplasty, pediatric urology, hydronephrosis, ureterocalicostomy.