Ureteropelvic junction (UPJ) or Pelvi-ureteric junction (PUJ) obstruction is a condition where a natural narrowing occurs at the junction between the renal pelvis and the ureter. The narrowing prevents normal drainage of urine from the kidney resulting in backlog of urine in the kidney (hydronephrosis) causing pain and even damage to the affected kidney. The condition is either picked up from routine examination. Sometimes, it is diagnosed because of loin pain which is aggravated by drinking a large amount of fluid. Your doctor may have made the diagnosis after doing an intravenous urogram (IVU) or intravenous pyelogram (IVP) or more commonly these days CT scan. The degree of obstruction so caused by the narrowing is usually assessed using excretory isotope renogram such as a DTPA or MAG3 study. If significant obstruction exists, surgical intervention is indicated to avoid further deterioration of the affected kidney.
Several operative options exist but excision of the narrow segment and reconstruction of the affection structure (pyeloplasty) gives the best results. Traditionally, this is done through a large incision which results in a lot of pain and unsightly scarring. Conventional laparoscopic reconstruction is technically challenging and the Da VinciĀ® operating system offers the much needed dexterity and precision for an accurate water-tight repair. The whole procedure is significantly less painful and most patients are out of hospital within 48 hours of surgery.