PUJ obstruction (PUJO)

Pelvi-ureteric junction (PUJ) obstruction, was also called as the ureteropelvic junction (UPJ) obstruction, will be one of the cause of an obstructive uropathy. Urine which was produced by the kidney was transiently stored in renal pelvis before coming down the ureter towards the bladder. In some people the junction in between the renal pelvis & the ureter was abnormal in the apperance & function, as such the urine won’t drain out from the kidney in the normal way. This was known as PUJ obstruction.


  • People who are having PUJ obstruction may experience a pain in their back or their side especially after they have consume alcohol or a lot of fluid.

  • They may also experience the urinary tract infection & blood in their urine. Abdominal mass, urinary tract infection along with fever, vomiting, kidney stones and poor growth in infants. UPJ obstruction can also cause pain without the infection.

  • In some cases of UPJ obstruction they were not clear. Urine will drain normally at some times, and at other times it may block. This may cause pain that comes & goes. The general belief was that most of the children were not in pain unless the urine becomes blockage or infected.


Most often UPJ obstruction was congenital. That means children were born with this health issue. It was not known how to prevent this occurrence. 1 in 1,500 children was born with this problem. The blockage may occurs as the kidney was forming. Today most cases were found by using ultrasound before the birth. Though it will occurs less frequent in the adults, UPJ obstruction can happen after the kidney stones, upper urinary tract swelling or surgery.


Ultrasonography was the preliminary screening test which tells completely about the degree & severity of the hydronephrosis (enlargement of the kidney) associated to the PUJ obstruction. Further, a diuretic renal scan (DRS) was needed to assess the urinary flow across PUJ & function of the kidneys.

Treatment may depends on the underlying causes. In a majority of the congenital cases, the condition was required benign & generally no intervention was required. Even though when there was a definitive structural obstruction (commonly adult cases), surgical intervention along with pyeloplasty or stenting may be essential.