Forming a stone in pelviureteric junction obstruction: Cause or effect?

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Vol. 43 (1): 13-19, January – February, 2017

doi: 10.1590/S1677-5538.IBJU.2015.0515


REVIEW ARTICLE

Theodora Stasinou 1, Andreas Bourdoumis 2, Junaid Masood 3

1 South Manchester University Hospitals NHS Foundation Trust, Manchester, UK; 2 North Manchester General Hospital, Acute Pennine Hospitals NHS Trust, Manchester, UK; 3 Homerton University Hospital NHS Foundation Trust, London, UK

ABSTRACT

Objectives: To investigate a possible causal relationship for stone formation in pelvi­ureteric junction obstruction and to outline management options.

Materials and Methods: A literature search and evidence synthesis was conducted via electronic databases in the English language using the key words pelviureteric junction obstruction; urolithiasis; hyperoxaluria; laparoscopic pyeloplasty; flexible nephros­copy; percutaneous nephrolithotomy, alone or in combination. Relevant articles were analysed to extract conclusions.

Results: Concomitant pelviureteric junction obstruction (PUJO) and renal lithiasis has been reported only scarcely in the literature. Although PUJO has been extensively studied throughout the years, the presence of calculi in such a patient has not received equal attention and there is still doubt surrounding the pathophysiology and global management.

Conclusions: Metabolic risk factors appear to play an important role, enough to justify metabolic evaluation in these patients. Urinary stasis and infection are well known fac­tors predisposing to lithiasis and contribute to some extent. The choice for treatment is not always straightforward. Management should be tailored according to degree of obstruction, renal function, patient symptoms and stone size. Simultaneous treatment is feasible with the aid of minimally invasive operative techniques and laparoscopy in particular.

Keywords:  Pelviureteric Junction Obstruction; Calculi; Urolithiasis; Nephrostomy, Percutaneous

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