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Conservative management of pelviureteric junction
Background Pelviureteric junction obstruction (PUJO) is defined as a functionally significant impairment of urine flow from the renal pelvis into the proximal ureter. For more than a century, surgery was considered the first-choice approach to management. However, the widespread use...
Which is better – laparoscopic or open paediatric pyeloplasty?
In an attempt to answer the above question, Gatti et al. undertook a randomised controlled trial between 2005 and 2014. All children aged 1 to 18 years of age requiring surgery for pelviureteric junction (PUJ) obstruction were enrolled. A total...The surgical management of female stress urinary incontinence in a post-mesh era
Trends in surgical management of women with stress urinary incontinence (SUI) have changed in recent times, mainly due to the ‘High Vigilance Pause’ placed on the use of mesh for SUI (and prolapse) surgery in July 2018 following an independent...
Lower pole vessels in children with PUJO: laparoscopic vascular hitch or dismembered pyeloplasty?
A crossing vessel accompanying pelvi-ureteric junction obstruction (PUJO) occurs in 25-50% of cases. The Hellstrom vascular hitch procedure was first described in 1951 and has regained popularity since 2003 in the era of laparoscopic surgery as it negates the need...Infections and inflammation: Part 1
See also Part 2 and Part 3. Case 1 A 59-year-old man presented with right loin pain. His GP arranged for him to have an intravenous urogram (IVU) and subsequent CT urogram performed. What is the likely diagnosis? What are...How to conduct an endoscopic séance
In this series of articles I am going to show you some of the exhibits contained in the Museum of Urology, hosted on the BAUS website (www.baus.org.uk). In the last article I agreed to tell you how to conduct an...
Outcome analysis of paediatric pyeloplasty
This prospective study from India included 744 patients of whom 112 had renal function less than or equal to 20% at the time of diagnosis. Thirty percent underwent a nephrostomy initially. Ten with no function had a nephrectomy. Of the...
A new treatment algorithm for ureteral fibroepithelial polyps in children
Fibroepithelial polyps are rare in the urinary tract (found in 0.5% of all paediatric pyeloplasties and 5% of all cases of paediatric ureteral obstruction). The advent of ureteroscopy in paediatrics has increased the identification and treatment of these. This paper...
PUJO: Hellstrom principle revisited
This paper describes the result of four out of twenty-three cases (two males, two females) of pelvi-ureteric junction obstruction - PUJO - (mean age 18.25 years, range 16-20), mean follow-up two years (range six months – three years) that were...
Prevention of urethral stricture recurrence
Urethral stricture recurrence after urethral reconstruction is one of the most challenging problems in urology. With the increase in endoscopic surgery over the last three decades the incidence of urethral strictures has increased, with iatrogenic manipulation the leading aetiology in...
Is robotic pyeloplasty in the under-ones as good as open repair?
Pelviureteric junction obstruction (PUJO) is a common cause of paediatric hydronephrosis. Indications for intervention include reduced renal function (<40%), symptoms (urinary tract infection or pain) and increasing dilatation. Although the Anderson-Hynes open pyeloplasty (OP) has long been the gold standard...
