Contemporary Diagnosis and Management of Ureteropelvic Junction Obstruction

Abstract

Ureteropelvic junction obstruction (UPJO) is defined as a functionally significant impairment of the flow of urine from the kidney’s renal pelvis into the proximal ureter. Symptomatically, the patient may experience flank pain, recurrent infections, stone formation, and impairment of renal function. Though many cases of intrinsic UPJO are diagnosed at birth, a minority of patients may present in adulthood with previously silent disease or develop secondary UPJO to other causes. UPJO is therefore broadly categorized into both primary UPJO and secondary UPJO. A wide array of diagnostic scans and tests are available to aid in diagnosing and monitoring patients with UPJO. In patients with compromised renal function or symptomatic UPJO that require intervention, minimally invasive techniques are the gold standard for surgical intervention. This review will detail the endoscopic, laparoscopic, and robotic options available to the urologist practicing in 2021, including the use of autografts and other emerging technologies.