Puj Obstruction

Some children are born with a condition called pelviureteric junction (PUJ) obstruction, which blocks the flow of urine from their kidneys to the bladder. Serious blockage can lead to a deterioration of the function in that kidney , so we asked consultant paediatric urologist Miss Marie-Klaire Farrugia how PUJ obstruction is diagnosed, and when surgery is considered as a treatment option.

Pelviureteric junction (PUJ) obstruction is most commonly due to a narrowing in the part of the ureter which drains urine from the kidney, causing a build-up of urine which then increases the pressure within the kidney - with the potential to cause damage.

PUJ obstruction is most often a congenital condition, occurring in 1 in 1500 births. It tends to affect the left kidney more than the right, but in 10% of cases it affects both kidneys.

What causes PUJ obstruction? PUJ obstruction can be:

• intrinsic - the blockage occurs inside, e.g. due to stenosis (a narrowing of the passage)
• extrinsic – the blockage is caused by an external factor putting pressure on the PUJ, such as an extra blood vessel crossing over the ureter.

It can be done by Laparoscopic and Open Pyeloplasty Surgery.