Forgotten kidney: asynchronous bilateral ureteropelvic junction obstruction

Area of Science:

• Urology
• Nephrology
• Pediatric Surgery

Background:

• Ureteropelvic junction obstruction (UPJO) is a common congenital anomaly.
• Contralateral nephrectomy for UPJO necessitates careful monitoring of the remaining kidney.
• Late-onset UPJO in a previously normal kidney is rare but possible.

Observation:

• A patient who underwent nephrectomy for UPJO presented nine years later with new-onset UPJO in the remaining kidney.
• The affected kidney was presumed normal at the time of the initial surgery.

Findings:

• The case demonstrates that the ureteropelvic junction can develop obstruction de novo, even years after a contralateral kidney was removed for the same pathology.
• This suggests potential underlying factors or mechanisms contributing to UPJO development beyond initial presentation.

Implications:

• Long-term surveillance of renal units after nephrectomy for UPJO is crucial.
• Further research into the etiology of late-onset UPJO is warranted.
• Management strategies may need to consider the possibility of delayed obstruction in the solitary kidney.