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Forgotten kidney: asynchronous bilateral ureteropelvic junction obstruction

S Michigan, P K Whelton, P C Walsh

    Urology
    |November 1, 1978
    PubMed
    Summary

    Ureteropelvic junction obstruction can develop years after a contralateral nephrectomy for the same condition. This case highlights the importance of long-term surveillance for renal units following such procedures.

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    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.

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