Are there any surgical options for UPJ reconstruction?

Peripelvic fibrosis, a scarred contracted renal pelvis, or an intrarenal pelvis in combination with a proximal ureteral stricture may prevent UPJ reconstruction by standard pyeloplasty or endopyelotomy. Two surgical options remain in this situation: ureteropyelostomy and ureterocalicostomy.

When to treat ureteropelvic junction ( UPJ ) obstruction?

Upon diagnosis of a ureteropelvic junction (UPJ) obstruction, prompt intervention is appropriate to prevent or minimize renal damage.

When do you need a nephrectomy for UPJ?

Performing nephrectomy is rare in UPJ obstruction; however, if the differential function is less than 10%, nephrectomy can be considered to relieve recurrent infection or renal hypertension. It is important to recognize that none of the above surgical indications are absolute.

When to use ureterocalicostomy as a reconstructive procedure?

This technique (ie, ureterocalicostomy) may also be used as the primary reconstructive procedure when a UPJ obstruction or proximal ureteral stricture is associated with a relatively small intrarenal pelvis. In this situation, repeat open or percutaneous pyeloplasty and balloon dilation carry high restricture rates.

Is there anything you can do about UPJ obstruction?

There does not appear to be anything one can do to prevent UPJ obstruction when it’s a genetic condition. In adults not born with UPJ obstruction, reducing the chances for later development would depend on avoiding kidney stones, urinary tract infections or trauma to the kidneys.

When do you need surgery for ureteropelvic junction obstruction?

If urine flow doesn’t improve and the obstruction remains after the first 18 months of life, surgery is usually needed to fix the problem. In infants, the surgery most often used is called open pyeloplasty. In this procedure the UPJ is removed, and the ureter is reattached to the renal pelvis but with a wider opening.

What are the outcomes of penile reconstruction surgery?

Penile Reconstruction Surgery Has High Success Rate and Outcomes. The flap is then rolled into a tube. This is then stitched to the groin vessel to form the penile replacement. Additionally, in most instances, a patient opts to have an internal penile pump inserted to facilitate sexual function and maintain erection.

How is the flow of urine affected by UPJ obstruction?

The kidneys filter the blood of waste matter and excess water, creating urine. The urine is pooled at the UPJ, and then flows down the ureters to the bladder. In UPJ obstruction, the flow of urine is slowed or stopped completely. This raises the risk of kidney damage. In most cases of UPJ obstruction, only one of the kidneys is affected.