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The pathophysiology of UPJ obstruction. Current concepts
1Department of Urology, University of Michigan, School of Medicine, Ann Arbor, USA.
The Urologic Clinics of North America
|June 20, 1998
Summary
Hydronephrosis, often seen in antenatal cases, is not always obstruction but requires monitoring. Even without immediate kidney damage, congenital hydronephrosis necessitates long-term follow-up due to potential evolving obstruction.
Area of Science:
- Urology
- Pediatric Urology
- Nephrology
Background:
- Hydronephrosis recognition evolved over 50 years; it's not always obstruction.
- Antenatal hydronephrosis requires careful consideration.
- Hydronephrosis is not a normal physiological state.
Purpose of the Study:
- To highlight the evolving nature of hydronephrosis and UPJ obstruction.
- To emphasize the need for long-term follow-up in asymptomatic congenital hydronephrosis.
Main Methods:
- Review of the pathophysiology of hydronephrosis.
- Analysis of the potential progression from initial stenosis to secondary obstructive elements.
Main Results:
- Initial non-obstructive hydronephrosis can develop secondary obstructive features.
- UPJ obstruction may represent stages of a dynamic pathophysiologic process.
Conclusions:
- Asymptomatic congenital hydronephrosis warrants long-term surveillance.
- Understanding hydronephrosis as a dynamic process is crucial for patient management.