What is Pelviureteric Junction Obstruction ?-Dr. Prashant Jain
Location: (Delhi)
It is a blockage or narrowing between the kidney pelvis and the ureter. PUJO impairs drainage of urine and this causes the urine to remain collected in the kidney causing swelling (Hydronephrosis). If it increases progressively then it causes back pressure on kidneys and subsequently affects the renal functions and may lead to a non functioning kidney.
How common is PUJ obstruction?About 1 in 1500 children’s have PUJ obstruction from birth (congenital). PUJ obstruction is one of the conditions that can cause hydronephrosis, which is the most common condition found in prenatal ultrasound.
What are the symptoms of PUJ obstruction?Sometimes there aren’t any outward symptoms of PUJ obstruction and it is only found when an ultrasound shows that the kidneys are swollen. This is called hydronephrosis. Some children may experience back or side (flank) pain, or a urinary tract infection (UTI). Some children experience pain that comes and goes.
How diagnosis of PUJ obstruction is confirmed ?The diagnosis of PUJ obstruction is confirmed by a study called a DTPA scan. A DTPA scan shows how well the kidneys are working and also about the severity of blockage.
How is PUJ obstruction treated ?The treatment for a PUJ obstruction depends on severity of the blockage. Blockages that are mild, appear to be stable or are improving over the time, will be monitored with ultrasound.
Blockage that are more severe or worsening can cause permanent kidney damage. These obstruction require a surgery to remove the portion of the blocked ureter. The surgery is called as pyeloplasty.
What is Pyeloplasty?Pyeloplasty is the procedure of choice for PUJ obstruction. The surgery involves removing the PUJ obstruction and joining the kidney pelvis onto the ureter (pyeloplasty). It has good results. This can be achieved through a traditional surgery (‘open pyeloplasty’) or by keyhole surgery (‘laparoscopic pyeloplasty’).
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