title: Management of ureteropelvic junction obstruction in adults.
abstract: Ureteropelvic junction obstruction (UPJO) is characterized by impaired flow of urine from the renal pelvis to the ureter. Untreated disease can result in renal impairment making effective management crucial. A combination of CT imaging and diuretic renography is typically used for diagnosis. CT is the investigation of choice for obtaining anatomical information about UPJO and can help to identify potential causes. Diuretic renography is best for providing functional information about UPJO. A variety of open and minimally invasive surgical techniques are available for treatment of UPJO. Traditionally open pyeloplasty has been the standard of care but minimally invasive surgical techniques have become increasingly popular. Endopyelotomy has a lower success rate than other modalities (42-90% depending on the approach), but is associated with reduced pain and shorter convalescence. Laparoscopic pyeloplasty and robot-assisted pyeloplasty have similar success rates to open pyeloplasty (>90%), with the additional advantages of significantly reduced morbidity and shorter convalescence. More long-term outcome data for minimally invasive surgical techniques are awaited.
authors.affiliation: Department of Urology, Guy's Hospital, Great Maze Pond, London, SE1 9RT, UK.
authors.forename: Fahd
authors.initials: F
authors.lastname: Khan
authors.affiliation: Department of Urology, Guy's Hospital, Great Maze Pond, London, SE1 9RT, UK.
authors.forename: Kamran
authors.initials: K
authors.lastname: Ahmed
authors.affiliation: Department of Urology, Guy's Hospital, Great Maze Pond, London, SE1 9RT, UK.
authors.forename: Nikiesha
authors.initials: N
authors.lastname: Lee
authors.affiliation: Department of Urology, Guy's Hospital, Great Maze Pond, London, SE1 9RT, UK.
authors.forename: Ben
authors.initials: B
authors.lastname: Challacombe
authors.affiliation: Department of Urology, Guy's Hospital, Great Maze Pond, London, SE1 9RT, UK.
authors.forename: Mohammed S
authors.initials: MS
authors.lastname: Khan
authors.affiliation: Department of Urology, Guy's Hospital, Great Maze Pond, London, SE1 9RT, UK.
authors.forename: Prokar
authors.initials: P
authors.lastname: Dasgupta
mesh_terms: D006801:Humans; D007682:Kidney Pelvis / Q000000981:diagnostic imaging / Q000601:surgery*; D010535:Laparoscopy / Q000379:methods*; D011866:Radioisotope Renography; D065287:Robotic Surgical Procedures; D014057:Tomography, X-Ray Computed; D014517:Ureteral Obstruction / Q000000981:diagnostic imaging / Q000601:surgery*; D013520:Urologic Surgical Procedures / Q000379:methods*