Congenital hydronephrosis has become the most common initial presentation of ureteropelvic junction (UPJ) obstruction with the widespread use of contemporary ultrasonographic techniques in the obstetric period.
The most common cause of prenatal hydronephrosis is UPJ obstruction. Dismembered pyeloplasty has been the criterion standard surgical therapy for UPJ obstruction.
The answer to this question forces the urological workup of potential UPJ obstruction and results in the application of surgical techniques to alleviate the obstruction and preserve renal function.
One of the most common congenital abnormalities of the urinary tract is Obstruction of the UPJ. Prior to the proliferation of prenatal ultrasonography, most cases of UPJ obstruction were not detected in the first year of life.
Intrinsic causes are inherent to the development and anatomy of the UPJ itself, while extrinsic causes are exterior to the UPJ. Additionally, it can be classified as primary and secondary.
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The cause of most intrinsic (or primary) UPJ obstruction likely relates to the embryological development of the urinary tract. During the fifth week of gestation, the ureteric bud forms from the wolffian duct and invades the metanephric blastema to begin renal differentiation.
Most occurrence of UPJ obstruction is found in children but may present in persons of any age. The clinical presentation of UPJ obstruction has changed dramatically because of the widespread proliferation of prenatal ultrasonography.
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Once the diagnosis of ureteropelvic junction (UPJ) obstruction has been made, management of this depends on the severity of the case. Indications for dismembered pyeloplasty or any other operative therapy are variable.