Management of pelviureteric junction obstruction at a tertiary teaching hospital in southwestern Nigeria: A retrospective analysis of case records

Background
Pelviureteric junction obstruction (PUJO) is an important cause of upper urinary tract obstruction. It can cause marked impairment of renal function, especially in bilateral cases, if not diagnosed and treated promptly. Surgical intervention is currently the mainstay of treatment. We aimed to review the pattern of presentation and management outcomes of patients diagnosed with PUJO.

Methods
We conducted a retrospective study of patients aged 2–60 years who presented with PUJO between January 2005 and December 2014. Demographic characteristics, clinical presentation, investigations, and treatment modalities were extracted from case notes. Data were analysed using SPSS version 20.

Results
The age range of the 32 included PUJO patients was 2–60 years, with a median age of 30 years. Children constituted 31% of patients. There were 15 males and a male-to-female ratio of 0.88:1. Most PUJO was unilateral and left-sided (n = 19; 59%). Loin pain was the commonest symptom (n = 26; 81%), while 25% of patients had a urinary tract infection at presentation. All patients had normal renal function at the time of surgery, and Anderson–Hynes pyeloplasty was the most common technique employed (72% of cases). Postoperatively, the majority of patients (n=31; 97%) had complete symptom resolution. Surgical site infection (n = 3; 9%) was the commonest postoperative complication, and the median hospital stay was 11 days. There was no mortality.

Conclusions
Most patients with PUJO presented late. Most of our patients underwent Anderson–Hynes pyeloplasty with satisfactory outcomes.

Keywords
pelviureteric junction obstruction; PUJO; loin pain; Anderson–Hynes pyeloplasty; Foley Y-V plasty; Nigeria