title: Forming a stone in pelviureteric junction obstruction: Cause or effect?
abstract: OBJECTIVE
  To investigate a possible causal relationship for stone formation in pelviureteric junction obstruction and to outline management options.
  
  
  METHODS
  A literature search and evidence synthesis was conducted via electronic databases in the English language using the key words pelviureteric junction obstruction; urolithiasis; hyperoxaluria; laparoscopic pyeloplasty; flexible nephroscopy; percutaneous nephrolithotomy, alone or in combination. Relevant articles were analysed to extract conclusions.
  
  
  RESULTS
  Concomitant pelviureteric junction obstruction (PUJO) and renal lithiasis has been reported only scarcely in the literature. Although PUJO has been extensively studied throughout the years, the presence of calculi in such a patient has not received equal attention and there is still doubt surrounding the pathophysiology and global management.
  
  
  CONCLUSIONS
  Metabolic risk factors appear to play an important role, enough to justify metabolic evaluation in these patients. Urinary stasis and infection are well known factors predisposing to lithiasis and contribute to some extent. The choice for treatment is not always straightforward. Management should be tailored according to degree of obstruction, renal function, patient symptoms and stone size. Simultaneous treatment is feasible with the aid of minimally invasive operative techniques and laparoscopy in particular.
authors.affiliation: South Manchester University Hospitals NHS Foundation Trust, Manchester, UK.
authors.forename: Theodora
authors.initials: T
authors.lastname: Stasinou
authors.affiliation: North Manchester General Hospital, Acute Pennine Hospitals NHS Trust, Manchester, UK.
authors.forename: Andreas
authors.initials: A
authors.lastname: Bourdoumis
authors.affiliation: Homerton University Hospital NHS Foundation Trust, London, UK.
authors.forename: Junaid
authors.initials: J
authors.lastname: Masood
mesh_terms: D006801:Humans; D006869:Hydronephrosis / Q000150:complications / Q000151:congenital* / Q000378:metabolism / Q000601:surgery; D007682:Kidney Pelvis / Q000601:surgery; D010535:Laparoscopy / Q000379:methods; D008659:Metabolic Diseases / Q000150:complications*; D021782:Multicystic Dysplastic Kidney / Q000150:complications* / Q000378:metabolism / Q000601:surgery*; D009403:Nephrostomy, Percutaneous / Q000379:methods; D012307:Risk Factors; D014517:Ureteral Obstruction / Q000150:complications* / Q000378:metabolism / Q000601:surgery*; D052878:Urolithiasis / Q000150:complications* / Q000378:metabolism / Q000601:surgery*
keywords: Calculi; Urolithiasis; Nephrostomy, Percutaneous; Pelviureteric Junction Obstruction