Treatment of Ureteropelvic Junction Obstruction

Ureteropelvic juction obstruction (UPJ) can be caused by narrowing of the ureter as it meets the renal pelvis, but it results most often from a physiologic obstruction. The lumen of the most proximal ureter is usually of normal size, but the smooth muscle that encircles the renal pelvis and ureter fails to conduct a peristaltic wave normally. The treatment, therefore, is directed at removing the narrowed or dysfunctional segment of proximal ureter.

The drawings depict a dismembered pyeloplasty. After excising the abnormal segment, the proximal ureter is spatulated (widened with a slit) and then reconnected to the renal pelvis.

 

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©David A. Hatch, M.D., 1996