Pelvi-ureteric junction (PUJ)

Acute

Pelvi-ureteric junction (PUJ)

Obstruction is a blockage that occurs at the junction between the renal pelvis and the ureter, preventing urine from flowing properly from the kidney to the bladder.

Symptoms

  • Flank pain or discomfort
  • Abdominal pain or discomfort
  • Nausea and vomiting
  • Fever and chills (if infection is present)
  • Hematuria (blood in urine)

Complaints

  • Intermittent pain or discomfort
  • Painful urination
  • Frequent urination
  • Urgent need to urinate

Causes

  • Congenital abnormalities
  • Kidney stones
  • Tumors
  • Inflammation or scarring
  • External compression

Risk Factors

  • Children and young adults
  • Individuals with family history of PUJ obstruction
  • People with certain medical conditions (e.g., kidney stones, urinary tract infections)

Prevention

While prevention is not always possible, maintaining a healthy lifestyle can reduce the risk:
  • Drinking plenty of water
  • Avoiding certain medications
  • Managing underlying medical conditions

Diagnosis

Diagnosis typically involves:
  • Imaging studies (e.g., ultrasound, CT scan)
  • Urodynamic studies (e.g., uroflowmetry)
  • Radioisotope studies (e.g., MAG3 scan)

Treatment

Treatment options depend on the cause and severity of the obstruction:
  • Surgery (e.g., pyeloplasty)
  • Endopyelotomy (minimally invasive procedure)
  • Nephrectomy (removal of the affected kidney) in severe cases
  • Stenting or catheterization to relieve obstruction

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