title: Pyeloureterostomy in the management of the lower pole pelvi-ureteric junction obstruction in incomplete duplicated systems.
abstract: OBJECTIVE
  To report our experience with the pyeloureterostomy (PU) for the treatment of the lower pole PUJO in incomplete duplex systems. The combination of the duplicated collecting system and pelviureteric junction obstruction (PUJO) is a rare association and infrequently reported. Surgical treatment can be challenging in such cases.
  
  
  METHODS
  We retrospectively reviewed the medical data of the patients who had surgery from 2001 to 2009, with a diagnosis of PUJO of the lower pole moiety in incomplete duplex system. Demographic, diagnostic, and procedural data were recorded.
  
  
  RESULTS
  Seven patients were identified with the lower pole PUJO associated with incomplete duplex systems. Their median age was 49 months (range 2-108 months). Prenatal hydronephrosis was detected in 3 patients, and 4 had a febrile urinary tract infection. PU was performed in 6 patients because of short ureteral length between the ureteropelvic junction and junction of lower and upper pole ureters. One patient was treated with the dismembered pyeloplasty because of sufficient ureteral length of the lower pole. No complications were detected during 14 months of follow-up.
  
  
  CONCLUSIONS
  The management of the lower pole PUJO in incomplete duplex systems should be individualized for every patient. PU is a good surgical option in the management of the lower pole PUJO associated with incomplete ureteral duplication.
authors.affiliation: Department of Pediatric Surgery, Mersin University, Faculty of Medicine, Mersin, Turkey. dinceravlan@yahoo.com
authors.forename: Dinçer
authors.initials: D
authors.lastname: Avlan
authors.forename: Gökhan
authors.initials: G
authors.lastname: Gündoğdu
authors.forename: Ali
authors.initials: A
authors.lastname: Delibaş
authors.forename: Ali
authors.initials: A
authors.lastname: Nayci
mesh_terms: D002648:Child; D002675:Child, Preschool; D005260:Female; D005315:Fetal Diseases / Q000175:diagnosis; D006801:Humans; D006869:Hydronephrosis / Q000175:diagnosis / Q000196:embryology / Q000209:etiology; D007223:Infant; D007668:Kidney / Q000000981:diagnostic imaging; D007682:Kidney Pelvis / Q000002:abnormalities* / Q000601:surgery*; D007685:Kidney Tubules, Collecting / Q000002:abnormalities*; D008297:Male; D011877:Radionuclide Imaging; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D014513:Ureter / Q000002:abnormalities* / Q000601:surgery*; D014517:Ureteral Obstruction / Q000209:etiology / Q000601:surgery*; D014519:Ureterostomy / Q000379:methods*; D014552:Urinary Tract Infections / Q000209:etiology