Pelvi-Ureteric Junction Obstruction (PUJO) | Dr. S K Palash
Urine flows from the kidneys to the bladder through thin tubes called ureters. However, when there is a blockage at the junction where the kidney’s pelvis meets the ureter, it can cause serious issues. This condition is known as Pelvi-Ureteric Junction Obstruction (PUJO).
As a leading Urologist & Andrologist in Baner, Pune, Dr. S K Palash provides expert diagnosis and advanced treatment options for PUJO to help preserve kidney function and improve patient outcomes.
What is PUJO?
PUJO is a condition where the flow of urine from the kidney to the bladder is obstructed at the pelvi-ureteric junction. This blockage prevents proper drainage of urine, leading to swelling of the kidney, known as hydronephrosis. If not treated in time, it can cause chronic pain, infections, and progressive loss of kidney function.
What Causes PUJO?
PUJO can be either congenital (present from birth) or acquired (develops later in life).
Congenital causes are more common and often result from abnormal development of muscles at the PUJ or due to a crossing blood vessel pressing on the ureter.
Acquired causes include:
Infections
Kidney stones
Trauma or injury
Previous surgeries
Inflammatory conditions
PUJO may also be intrinsic (originating within the junction) or extrinsic (caused by external compression).
What are the Symptoms of PUJO?
Symptoms may vary based on the severity of obstruction and age of the patient. Common symptoms include:
Dull flank or back pain, especially after drinking fluids
Recurrent urinary tract infections (UTIs)
Blood in urine (hematuria)
Nausea, vomiting, or abdominal fullness
Detection on prenatal ultrasound (in babies)
Poor growth in children, in severe cases
How is PUJO Diagnosed?
Accurate diagnosis is key to effective treatment. Dr. S K Palash recommends the following tests:
Diuretic Renogram (DTPA/EC scan): Assesses urine flow and kidney function
IVP (Intravenous Pyelogram): Visualizes the urinary tract anatomy
MRI/CT Urography: Used in complex or unclear cases for detailed anatomical study
What are the Treatment Options?
Treatment depends on the severity of the obstruction and the kidney’s functional status.
1. Observation
Mild cases with no major symptoms and good kidney function may only require regular monitoring.
2. Definitive Treatment – Pyeloplasty
Anderson-Hynes Pyeloplasty is the gold standard surgical treatment.
The narrowed PUJ is removed and the healthy ends are reconnected.
Can be performed via:
Open surgery
Laparoscopic surgery (minimally invasive)
Robotic-assisted surgery (advanced, precise)
3. Endopyelotomy
A less invasive method involving internal cutting of the obstruction. However, it has lower long-term success rates compared to pyeloplasty.
4. Prenatal PUJO
In cases detected during pregnancy, the condition is monitored post-birth.
Surgery is recommended only if the obstruction worsens after delivery.
Is Surgery Always Required?
Not in all cases. If:
Kidney function is preserved
Obstruction is mild
Symptoms are absent or minimal
Then, observation with regular follow-up may be enough. Surgery is advised when:
Pain or discomfort is persistent
Repeated UTIs occur
Kidney function begins to decline
Hydronephrosis worsens
What is the Success Rate of Pyeloplasty?
When performed by an experienced urologist like Dr. S K Palash, pyeloplasty has a success rate of over 90–95%. It is highly effective in relieving the blockage and preserving kidney function.
Is PUJO a Lifelong Condition?
With timely and appropriate treatment, especially surgery, most patients recover completely and lead normal, healthy lives. However, long-term follow-up is important—especially in children—to ensure proper kidney development and function.
Can PUJO Cause Kidney Failure?
Yes—if left untreated, severe PUJO can lead to permanent kidney damage or failure in the affected kidney. This is why early detection and intervention are crucial.
When Should You Consult a Urologist?
You or your child should see a urologist if you experience:
Persistent flank or abdominal pain
Repeated urinary infections
Abnormal findings on ultrasound
Decline in kidney function
Suspecting PUJO in Yourself or Your Child? Don’t Delay.
Early diagnosis and expert urological care can prevent long-term kidney damage. If you're in Baner, Pune, consult Dr. S K Palash for accurate evaluation and safe, effective treatment options tailored to your needs.
Visit Dr. S K Palash – Your Trusted Urologist & Andrologist in Baner, Pune
Take the first step towards protecting your kidney health. Book your consultation today.
Disclaimer: The information provided here should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. The information is provided solely for educational purpose and should not be considered a substitute for medical advice.
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