Disease
Pelviureteric Junction Obstruction
What is Pelviureteric Junction Obstruction (PUJO)?
Pelviureteric Junction Obstruction (PUJO) is a condition where the flow of urine from the renal pelvis (the part of the kidney that collects urine) into the ureter (the tube that carries urine to the bladder) is blocked or restricted. This can lead to swelling of the kidney, known as hydronephrosis, and may cause kidney damage if left untreated.
Causes :
Pelviureteric Junction Obstruction can be:
- Congenital (present at birth) due to abnormal development of the urinary tract.
- Acquired later in life due to:
- Kidney stones
- Scar tissue from infections or surgery
- Tumors pressing on the ureter
- Inflammation or crossing blood vessels compressing the junction
Who is Affected?
PUJO commonly affects newborns and children but can also occur in adults. In children, it is often detected through prenatal ultrasound. In adults, it may present with pain or urinary tract symptoms.
Symptoms:
- Flank or abdominal pain (especially after fluid intake)
- Recurrent urinary tract infections
- Hematuria (blood in urine)
- Nausea or vomiting
- Poor growth in children (in long-standing cases)
Diagnosis
PUJO is usually diagnosed through imaging tests such as:
- Ultrasound
- CT Urography
- MRI Urography
- Renal scan (DTPA or MAG3) to assess kidney function and drainage
Treatment Options:
Treatment depends on severity:
- Mild cases may just need observation.
- Severe or symptomatic PUJO often requires surgery.
The standard surgical treatment is:
- Pyeloplasty: A procedure to remove the narrowed section and reconnect the healthy ends to restore urine flow.
