Is a stent necessary prior to CUPJ laparascopic surgery

[Greythounds]

Dear all,

I would love some feedback on my problem.
I'm in my 40's and a few years back I was diagnosed with a CUPJ narrowing (congenital ureteropelvic junction) via CT-scan. Since I was relatively symptom free at that point nothing was done about it.
Now I suddenly do have symptoms: flank pain, fatigue, kidney pressure, but not at all times, mostly when lying down, after strenuous work-outs or large meals/drinks.
I had a repeat CT-urogram as well as a kidney/bladder ultrasound.

Both CT-urogram & ultrasound showed moderate right hydronephrosis with no perinephric stranding nor cortical thinning which was unchanged since the CT scan from 3 years ago. Right pelviectasis over right caliectasis and proximal right ureteral dilation.

My Urologist would like to do a right ureter stent procedure for 4 to 8 weeks and then perform a robotic laparoscopic surgery to cut away the narrowing part of the ureter and stitch back together.

My questions :

1) Would it be wrong to immediately go for the laparoscopic surgery and skip the 4 to 8 weeks stent period?
I am able to allow & arrange full rest & recovery for myself for 4 weeks after a lap surgery, but not during a stent period

2) I have read numerous disheartening experiences with ureteral stents, most people don't seem to be able to be strenuously active. This is of major importance to me!!
I have horse farm and ride dressage horses competitively as well as daily lifting of heavy loads (+/- 50lbs). I have been told by my Urologist that as of day 2 past stent insertion I will for sure be able to continue to do all those activities for the 4 to 8 week period.
I am seriously worried about the correctness of this statement.
If there's even only a 10% change I may not be able to ride the horses and do the farmwork then I need to be made aware of this *prior* to the stent insertion.
In that case I would much prefer to have the laparoscopic surgery immediately, then I can close the farm and move the horses to another facility for a month whilst I work on my recovery.
I have no back up or help on the farm available and for various reasons I am not in a position to close the farm for 4 to 8 weeks whilst I struggle with a stent and then close the farm another month for the laparascopic surgery recovery period.

What is the % of people able to resume their daily activities whilst having a ureteral stent in place?

I'd like to call out to all people who have had experience with stents: were you able to stay physically active and sport intensively? Please describe your positive experiences with this or your struggles. Thank you so much!!

3) Do all CUPJs need to be corrected? I was told there was no need for a surgical correction 3 years ago, why is it necessary now, considering my recent CT scan shows no change since the CT scan from 3 years ago.
Could my kidney pain symptoms be due to a different reason, and thereby the surgery may not even help my current flank pain?

Many thanks to anyone able to give me some info/advice, words of encourgament :)

[cmropen]

Getting a second opinion from another urologist may be a way to proceed if you are unsure about the surgery or still have questions.