Obstruction ureteropelvic junction

Brooks JD, Kavoussi LR, Preminger GM et al (1995) Comparison of open and endourologic approaches to the obstructed ureteropelvic junction. Urology 46 791-795... 

Taha MA, Shokeir AA, Osman HG, Abd El-Aziz Ael-A, Farahat SE. Obstructed versus dilated nonobstructed kidneys in children with congenital ureteropelvic junction narrowing role of urinary tubular enzymes. J Urol. 2007 178 640-6. 

Fig. 1.83. Ureteropelvic junction obstruction. Longitudinal US scan of the right kidney demonstrates dilated calyces communicating with a markedly dilated renal pelvis (P). No dilated ureter is identified...

Fig. 1.1.10. Antegrade pyelography combined with the Whitaker test on general anesthesia in a 6-month-old baby. No reflux. Slight dilatation on ultrasound and IVU. Diuresis renography had not been conclusive, and the Whitaker test showed obstruction at the ureteropelvic junction. Surgery was subsequently performed...

Fig. 1.1. 12. Antegrade pyelography combined with the Whitaker test. Intermittent obstruction at the ureteropelvic junction in a child with equivocal results on diuresis renography. Constant flow renal perfusion (5 cc/min). Transient peak in pelvic and differential pressures are shown and complete the criteria for obstruction...

Chertin B, Pollack A, Koulikov D, Rabinowitz R, Hain D, Hadas-Halpren I, Farkas A (2006) Conservative treatment of ureteropelvic junction obstruction in children with antenatal diagnosis of hydronephrosis lessons learned after 16 years of follow-up. Eur Urol 49 734-738 discussion 739... 

Elder JS, Stansbrey R, Dahms BB, Selzman AA (1995) Renal histological changes secondary to ureteropelvic junction obstruction. J Urol 154, Pt 2 719-722... 

Huang WY, Peters CA, Zurakowski D, Borer JG, Diamond DA, Bauer SB, McLellan DL, Rosen S (2006) Renal biopsy in congenital ureteropelvic junction obstruction evidence for parenchymal maldevelopment. Kidney Int 69 137-143... 

Pascual L, Oliva J, Vega-P J, Principi 1, Valles P (1998) Renal histology in ureteropelvic junction obstruction are histological changes a consequence of hyperfiltration J Urol 160, Pt 2 976 discussion 994... 

Rooks VJ, Lebowitz RL (2001) Extrinsic ureteropelvic junction obstruction from a crossing renal vessel demography and imaging. Pediatr Radiol 31 120-124... 

Familial aggregation of hydronephrosis in families with ureteropelvic junction obstruction has been described in several studies. In many cases hydronephrosis can he regarded as manifestation of a spectrum including hydronephrosis - cortical renal cysts (Potter type IV) - hypoplastic/dysplastic or multicystic kidneys - renal agenesis, depending on the time of the interaction of a disruption (e.g. obstruction). Hydronephrosis can also be a part of more complex genetic syndromes (Table 3.4). 

Ureteropelvic junction obstruction by a high ureteral insertion or an anomalous renal vessel is the most common cause of hydronephrosis, which occurs in 30% of patients diagnosed during life. Urolithiasis develops in 20% of patients with a horseshoe kidney. Stasis secondary to hydronephrosis, but with metabolic factors are also the reasons (Evans and Resnick 1981). 

Kramer SASA, Kelalis PP (1984) Ureteropelvic junction obstruction in children with renal ectopy. J Urol 5 331-336... 

Ureteropelvic junction obstruction (UPJ) represents the leading cause of dilatation of the urinary tract (about 35%-40% of the cases). Its origin is not always understood or can be interpreted as multifactorial. UPJ obstruction can result from anatomic anomalies or abnormal peristalsis. At surgery, muscular discontinuity or extrinsic compression of the UPJ due to vessels or ureteral kinks can be found. MR imaging can very nicely display the crossing... 

Riccabona M, Ring E, Fueger G et al (1993) Doppler sonography in congenital ureteropelvic junction obstruction and congenital muticystic kidney disease. Pediatr Radiol 23 502-505... 

Homsy 1995 Homsy et al. 1990 Mouriquand et al. 1999). The most common causes are obstruction at the ureteropelvic junction (UPJ) and fetal VUR. On the basis of the neonatal findings, several authors tend to differentiate between obstructive and nonobstructive UPJ. The other causes of urinary tract dilatation are listed in Table 13.1. The US approach to a dilatation of the fetal urinary tract is similar to that after birth. The aim of US is to... 

Tapia J, Gonzalez R (1995) Pyeloplasty improves renal function and somatic growth in children with ureteropelvic junction obstruction. J Urol 154 218-222 Thomas DFM (1990) Fetal uropathy. Br J Urol 66 225-231 Tibballs JM, De Bruyn R (1996) Primary vesicoureteric reflux how useful is postnatal ultrasound Arch Dis Child 75 444-447... 

Fig. 20.9. A 3-month-old boy with ureteropelvic junction obstruction. Sonogram of right kidney showing hydronephrosis and nephrocalcinosis...

Struvite stones are mainly seen in boys under the age of 5 years (Fig. 20.8). In one-third of patients there is a primary anomaly of the urinary tract, most often a ureteropelvic junction obstruction... 

This classification does not take into account the possible ureteric injuries that are known to be more frequent in children than in adults (Reda and Lebowitz, 1986). Uretero-pelvic junction disruption is the most common location in cases of blunt abdominal trauma it predominates in children with ureteropelvic junction obstruction. Diagnosis is difficult due to the usual absence of hematuria. 

Badlani G, Eshghi M, Smith A (1986) Percutaneous surgery for ureteropelvic junction obstruction (endopyelotomy) technique and early results. J Urol 135 26-28... 

---