"Clear the Blockage, Save the Kidney: Specialized Care for PUJ Obstruction"
Pelvi-Ureteric Junction (PUJ) Obstruction is defined as the blockage which occurs at the point of convergence between the renal pelvis and ureter. This junction is specifically where urine produced by the kidney is drained into the ureter which then transports it to the bladder. The obstruction prevents urine from being excreted out of the kidney into the ureter and as a result, the kidney becomes distended with urine – hydronephrosis. If this state is ignored, it may bring about adverse effects to the kidney.
Causes
Congenital
Most cases of PUJ obstruction are congenital or acquired at the time of birth. It occurs due to abnormal development of the muscles or the surrounding tissues at the PUJ leading to functional obstruction.
Acquired
In adult populations, it can be caused by kidney stones, prior surgery, scar tissues, or proximity to vascular structures that can compress it.
Diagnosis
Ultrasound
Usually performed first and reveals the presence of hydronephrosis.
Intravenous Pyelogram (IVP)
Uses X-ray and injection of dye to view the urinary tract.
CT Scan or MRI
Obtains clear images of the urinary system.
Renal Scan
Evaluates kidney function as well as the extent of blockage.
Symptoms of Pelvic-Ureteric Junction (PUJ) Obstruction
The Pelvi-Ureteric Junction (PUJ) Obstruction symptoms would differ from one individual to another based on the extent of obstruction which may be congenital (from birth) or developed later in life.
Treatment
Observation and Monitoring
Surgical Intervention
Nephrostomy
Nephrectomy
Therapy consisting of Antibiotics
Resuming activities and health monitoring
Comprehensive Approach to Care
The Pelvi-Ureteric Junction (PUJ) Obstruction compromises kidneys and therefore the quality of life of the patients. Learning the clinical presentation, diagnosis, and treatment is of utmost importance regarding the management of such a condition. For those patients, early diagnosis and proper treatment are the means to avert any complications in the long run and consequently improve the quality of life of the patients.