Clinical features and treatment of pelvi-ureteric junction obstruction in duplex kidney
10.3760/cma.j.issn.1000-6702.2011.03.015
- VernacularTitle:重复肾合并肾盂输尿管连接部梗阻的诊治特点分析
- Author:
Yisen MENG
;
Wei YU
;
Shiliang WU
;
Yunxiang XIAO
- Publication Type:Journal Article
- Keywords:
Duplex kidney;
Pelvi-ureteric junction obstruction;
Reconstructive surgical procedures
- From:
Chinese Journal of Urology
2011;32(3):192-195
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the clinical features and treatment of pelvi-ureteric junction obstruction (PUJO) in a duplex kidney. Methods From 1993 to 2010, 752 patients were diagnosed as PUJO in our hospital and 18 patients (2.4%) with PUJO in duplex kidneys. Three patients had obstruction in the complete duplicated systems and 15 in the incomplete duplicated systems. Five patients had obstruction of the upper moiety and 13 of the lower moiety. All of the 18 patients underwent B-ultrasonography, with 15 enhanced CT scan, 11 intravenous urography and 10 retrograde pyelography.All patients had serum creatinine test after admission and during the follow-up. Results Sixteen patients underwent operations and 2 patients were treated conservatively. Nine patients underwent pyeloplasty and 7 patients underwent heminephroureterectomy. Pathology shows derangement of the lamina muscularis at pelvi-ureteric junction and infiltration of inflammatory cells in mesenchymal. They were followed up from 6 months to 3 years with a mean of 24 months. The clinical symptoms of patients who underwent surgery were cured in all cases. B-ultrasound and IVU showed that hydronephrosis was obviously relieved and the levels of serum creatinine remained the same or decreased. The hydronephrosis and serum creatinine of patients who underwent conservative treatment remained stabilized. Conclusions PUJO in duplicated system is a rare condition. Careful preoperative evaluation is needed to reach the final diagnosis and retrograde pyelography has high specificity. Treatment should be individualized according to split and partial renal function.
