Presentation and early surgical outcomes of subjects with pelvic ureteric junction obstruction in northern zone of Tanzania

Abstract

Objectives: The study aimed at describing presentation and early surgical outcomes of patients with pelvic ureteric junction obstruction in northern zone of Tanzania.

Methods: This was a hospital based descriptive, retrospective study conducted from January 2005-August 2014 using structures data extraction form. All Data from the time of presentation to the KCMC hospital up to three-month post pyeloplasty were extracted from eligible patients. In this study success rate was defined as the percentage of subjects who fared well post pyeloplasties, without being re-operated due to the same diagnosis (PUJO) within three months after pyeloplasty.

Results: The study involved 24 subjects with mean age of 28 years. Majorities were men 14 (58.3%) and flank pain being the main presenting complaint 21 (87.5%), followed by flank mass 5 (20.8%). The most common cause of PUJO was primary intrinsic (narrowing) of Pelvic Ureteric Junction (PUJ) 19 (79.2%) with right side being most affected site. All subjects, 24 (100%) had various open surgical intervention with dismembered pyeloplasty only being the common surgical procedure 16(66.7%). Five (20.8%) subjects developed different complication; persistent pain being the common complication in two subjects. Four of five subjects who developed complication had undergone dismembered pyeloplasty.

Conclusion: PUJO has male predominance in our centre with the most common presenting symptom being flank pain followed by flank mass. Congenital intrinsic stenosis/narrowing at PUJ is the common cause of PUJO. Open Anderson-Hynes dismembered pyeloplasty is the commonest procedure in our centre which has 100% success rate.