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Ureteropelvic Junction Obstruction
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==Answers== #What are the causes of UPJO? ##Congenital '''SHAVA''' ###True ureteral '''S'''tricture ###'''H'''igh insertion; found more frequently in the presence of renal ectopia or fusion anomalies ###'''A'''berrant vessels (controversy persists). Regardless, the presence of crossing vessels has a detrimental effect on the success rates of endopyelotomy ###Kinks or '''V'''alves produced by infoldings of the ureteral mucosa and muscularis ###'''A'''peristaltic segment ##Acquired '''CRIBS''' ###Cancer ###Reflux ###Ischemia ###Benign tumour ###Stones #What are the indications for intervention in UPJO? ##Symptoms ##Stones ##Renal insufficiency ##Infections ##Causal HTN #What are the options for intervention in UPJO? ##Observation ##Diversion (stent or nephrostomy tube) ##Endoscopic (balloon dilation, endopyelotomy) ##Pyeloplasty ##Ureterocalycostomy #How long is a stent kept for following pyeloplasty? ##4-6 weeks #When should a ureterocalycostomy be considered? ##Small renal pelvis ##Dependent drainage in malrotated/ectopic kidney ##Failed pyeloplasty #What are the contraindications to endopyelotomy? ##Stricture > 2cm ##Active infection ##Uncontrolled coagulopathy
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