Pelvi-ureteric junction obstruction as seen in University of Maiduguri Teaching Hospital: A six-year experience

Abstract

Background: Pelvi-ureteric junction obstruction is defined as narrowing or kinking of the junction between the ureter and the renal pelvis, that is associated with symptoms and or complications. It can result from a congenital narrowing or external compression by aberrant vessels, fibrous band or peri-ureteric fibrosis. The obstruction however may be due to impacted stone. It can be unilateral or bilateral and associated with complications ranging from pyelonephritis, nephrolithiasis and impaired renal function. Surgical procedures for treating this condition include minimally invasive techniques like laparoscopic pyeloplasty and open pyeloplasty. Objective: To determine the clinical presentation and outcome of Pelvi-Ureteric Junction (PUJ). Materials and method: We retrospectively reviewed all patients that were managed as pelvi-ureteric junction obstruction in University of Maiduguri Teaching Hospital between January 2006 to December 2011. Information was obtained from clinical records and laboratory results. Data was analysed using PASW statistic18. Results: A total of 73-patients were analysed. Fifty-four of the patients were males and 19 females, ratio of 3:1, age ranged from 15months-55yrs, mean of 26.77 ± 12.78. The peak age is 20-29(35.62%), with over 70% of the patients presenting within the age of 10-39years. The cardinal features were loin pain, loin tenderness, fever, and nausea/vomiting occurring in, 63(86.30%), 42(57.53%), 37(50.68%), and 28(38.36%) patients respectively. Associated co-morbidities were diabetes in 6 patients (8.22%), hypertension in 3(4.11%), HIV in 4(5.48%) and asthma in 1(1.37%). Conclusion: Pelvi-ureteric junction obstruction is common in this environment but patients present late with complications. Therefore early diagnosis and prompt treatment is necessary for good outcome.