Pelviureteric junction obstruction in adults: A systematic review of the literature

Abstract

BackgroundPelviureteric junction obstruction (PUJO) is a common urological disorder that can present at any stage of life. The underlying etiology in children has been well studied; however, a gap exists in the literature for the adult population. Herein, we performed a systematic review of the literature to evaluate the current evidence on the underlying etiologies of adult patients presenting with PUJO.Materials and methodsFour electronic databases were searched for relevant studies assessing the underlying etiologies of pelviureteric junction obstruction in adults. Studies were assessed for eligibility based on predefined inclusion and exclusion criteria, and a critical appraisal of methodological quality and risk of bias was performed. Finally, qualitative and quantitative data analyses were performed.ResultsTwelve studies comprising a total of 513 patients with radiologically confirmed PUJO met the inclusion criteria and were included in our analysis. The most common finding was crossing vessels, which were observed in 50.5% of patients, followed by intrinsic ureteral stenosis (27.1%), adhesions (15.3%), and high insertion of the ureter (10.1%).ConclusionsThe underlying etiologies of PUJO in adults remain unclear. This study indicated that obstruction secondary to crossing vessels is the most common cause of obstruction in adults and occurs more frequently than in the pediatric population.

Case Report; Concomitant Left Nutcracker Syndrome and Right Ureteropelvic Junction Obstruction

“…Deterioration of renal function or symptoms such flank discomfort or infection are reasons to consider surgery. 4 Within the proper follow-up protocols, successful conservative therapy of asymptomatic cases in youngsters has been recorded. 10 The robotic approach seems to add further technical advantages when compared to conventional LP but sustains a higher costs.…”