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Summary
Ureteropelvic junction obstruction (UPJO) in adults is often missed, leading to delayed diagnosis and treatment. Early detection and imaging are crucial, especially when accessory renal vessels are present.
Area of Science:
- Urology
- Nephrology
Background:
- Ureteropelvic junction obstruction (UPJO) is more prevalent in adults than commonly recognized.
- It can present with nonspecific symptoms, mimicking other conditions and leading to diagnostic delays.
Purpose of the Study:
- To highlight the challenges in diagnosing adult UPJO.
- To emphasize the association with accessory renal vessels and recommend diagnostic strategies.
Main Methods:
- Retrospective analysis of 31 adult patients with UPJO.
- Review of diagnostic imaging and surgical outcomes.
Main Results:
- Average diagnostic delay was 3.2 years; only 13% diagnosed initially.
- Nephrectomy rate was 24%.
- Accessory lower pole vessels occurred in 52% of adults, double the rate in children.
Conclusions:
- Adult UPJO diagnosis is frequently delayed, necessitating increased awareness.
- High prevalence of accessory vessels in adults warrants consideration of specific imaging like IVDSA and diuretic RNR.
- Close ultrasonographic follow-up is vital for the remaining kidney, particularly post-nephrectomy or with contralateral accessory vessels.