Related Experiment Video
Updated: Aug 7, 2026
Assessing Urinary Tract Junction Obstruction Defects by Methylene Blue Dye Injection
Published on: October 12, 2017
Diagnostic difficulties in children with coexisting pelvi-ureteric and vesico-ureteric junction obstruction
Ali Cay1, Mustafa Imamoglu, Elif Bahat
1Paediatric Surgery , Karadeniz Technical University Medical Faculty, Trabzon, Turkey. dralicay@yahoo.com
Insights
Diagnosing children with simultaneous pelvi-ureteric junction (PUJ) and vesico-ureteric junction (VUJ) obstruction presents challenges. Early detection and treatment are crucial to preserve kidney function and ensure surgical success.
Area of Science:
- Pediatric Urology
- Surgical Management
- Diagnostic Imaging
Background:
- Coexisting pelvi-ureteric junction (PUJ) and vesico-ureteric junction (VUJ) obstruction in children poses significant diagnostic challenges.
- Delayed diagnosis can lead to renal function deterioration and impact surgical outcomes.
Purpose of the Study:
- To evaluate the diagnostic difficulties and management strategies for children with coexisting PUJ and VUJ obstruction.
- To highlight the importance of early diagnosis and treatment in preventing renal damage.
Main Methods:
- Retrospective analysis of 14 pediatric patients surgically treated for coexistent PUJ and VUJ obstruction (1994-2005).
- Review of English-language published literature on similar cases.
- Assessment of diagnostic accuracy using uroradiological techniques.
Main Results:
- Surgery was performed on all 14 patients.
- Accurate pre-operative diagnosis was achieved in only five patients.
- Six patients received a diagnosis post-pyeloplasty, and three were diagnosed later during investigations for associated anomalies.
Conclusions:
- Coexisting PUJ and VUJ obstruction in children presents considerable diagnostic hurdles.
- Early diagnosis and prompt treatment are essential to prevent irreversible renal function decline.
- Clinicians should consider the possibility of dual obstruction when evaluating pediatric patients with urinary tract anomalies.
Objective:
To assess the diagnosis of children with coexisting pelvi-ureteric junction (PUJ) and vesico-ureteric junction (VUJ) obstruction, and the management of such patients, as having these two anomalies in the same ureter creates serious diagnostic difficulties, but any delay in diagnosis might cause a deterioration of renal function and affect the success of surgery to correct either anomaly.
Patients And Methods:
We assessed the diagnostic difficulties and approach to 14 patients with coexistent PUJ and VUJ obstruction, who were treated surgically in our clinic between 1994 and 2005; we also review related published reports in English.
Results:
Surgery was used in all 14 patients over the 11-year period; only five patients had an accurate diagnosis before surgery. Six patients were diagnosed with uroradiological techniques immediately after pyeloplasty; three were diagnosed on investigating an associated anomaly later.
Conclusion:
In children with coexisting PUJ and VUJ obstruction there are serious diagnostic problems; to prevent any deterioration in renal function due to obstruction, these anomalies require early diagnosis and treatment. For an early and accurate diagnosis, the coexistence of these two anomalies in the same ureter should be considered.
Related Concept Videos
01:22Imaging Studies V: Intravenous Urography and Retrograde Pyelography
01:22Imaging Studies VI: Voiding Cystourethrography and Cystography
01:22Ureters
01:26Urinary Tract Calculi II: Pathophysiology and Clinical Manifestations
01:30Urinary Tract Infection III: Diagnostic Studies and Interprofessional Care
01:28Urinary Tract Calculi I: Introduction