Pelviureteric junction obstruction: A surgical experience

Abstract

Objective: To describe the experience in the management of patients with intrinsic pelviureteric junction obstruction in the town of Mombasa, Kenya.

Methods: This was an evaluation of the patients operated upon by the authors between 1995 and 2003. The thirteen patients subjected to surgery are presented.

Results: Thirteen patients with pelviureteric junction obstruction aged 2 to 38 years, with a mean age of 20 years were studied. Male: female ratio was 10:3. The left side was more commonly affected in a ratio of 8:5. Six patients had Y-V pyeloplasty, five had dismembered pyeloplasty and two had nephrectomy. Seven patients had double ‘J’ stents inserted. Two patients had complications; one had prolonged urine leak of one month after unstented dismembered pyeloplasty, and the other had a broken stent. Two boys with a tentative diagnosis of pelviureteric junction obstruction turned out to have a right renal carcinoma, and a variant of polycystic kidney on the left. Both had nephrectomy, and excluded from the study.

Conclusion: Pelviureteric junction obstruction is an uncommon condition. Results of reconstructive surgery are good with few complications. Despite clinical and radiological features suggesting intrinsic pelviureteric junction obstruction, the possibility of other pathology should always be borne in mind.