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Management of uretero-pelvic obstruction in developing countries
V C Onuora1, A H Koko, A N Jasser
1Department of Urology, Riyadh Medical Complex, Saudi Arabia.
East African Medical Journal
|August 1, 1996
Summary
Congenital pelvi-ureteric junction (PUJ) obstruction, often diagnosed via ultrasound, can impair kidney drainage. Early surgical intervention may improve kidney outcomes, especially in regions with limited follow-up care.
Area of Science:
- Urology
- Pediatric Surgery
- Nephrology
Background:
- Congenital pelvi-ureteric junction (PUJ) obstruction is a common cause of impaired renal drainage.
- Increased use of ultrasound has led to more diagnoses of equivocal PUJ obstruction, particularly in children.
- Inadequate surveillance in developing countries poses challenges for managing PUJ obstruction.
Purpose of the Study:
- To evaluate the outcomes of adult patients with congenital pelvi-ureteric junction obstruction.
- To assess the implications of increased pediatric diagnoses of equivocal PUJ obstruction.
- To propose optimal management strategies for PUJ obstruction, considering resource limitations.
Main Methods:
- Retrospective review of 36 renal units in 34 adult patients explored for impaired pelvic drainage.
- Analysis of primary nephrectomy rates and follow-up data.
- Discussion of diagnostic trends and management recommendations based on clinical experience.
Main Results:
- Congenital PUJ obstruction was identified in 29 of 36 explored renal units.
- A primary nephrectomy rate of 8.4% was observed.
- Follow-up data was noted to be poor.
Conclusions:
- Early surgical intervention for pelvi-ureteric junction obstruction may lead to better renal salvage.
- This approach is particularly relevant in developing countries with inadequate surveillance systems.
- Timely management is crucial for preserving renal function in patients with PUJ obstruction.