Obstruction ureterovesical junction

Anuria has occurred after silver nitrate irrigation for intractable bladder hemorrhage caused by cyclophosphamide chemotherapy (40). The level of obstruction was the ureterovesical junction on the one hand, and the collecting ducts of the renal papillae on the other. Therapy... 

Fig. 1.2.11a,b. A 3-month-old boy with non-obstructive megaureter and simple ureteroceles, a Volume-rendered image showing bilateral hydroureteronephrosis. The renal transit time was normal bilaterally, b Detailed imaging of the ureterovesical junction showing simple ureteroceles... 

The dynamic renogram is only of diagnostic value if glomerular renal function is normal and both kidneys appear normal in the ultrasonographic evaluation. It is important that dynamic renography is performed with an empty bladder to exclude an obstruction at the ureterovesical junction. Therefore, in infants the use of an indwelling bladder... 

If the ureter is very large, a low-end ureterostomy maybe performed allowing the ureter to decompress before carrying out a reimplantation. Like pelviure-teric junction obstruction, management of ureterovesical junction obstruction is often nonoperative initially. One study (Liu et al. 1993) found that 34% resolved spontaneously, 49% persisted, and only 17% required a reimplantation due to infections or deteriorating renal function. 

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