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PUJO Treatment in Gomti Nagar Extension, Lucknow – Swastik Urology Clinic
PUJO (pelviureteric junction obstruction) is a treatable cause of kidney dilation and impaired renal drainage. At Swastik Urology Clinic in Gomti Nagar Extension, Lucknow, we provide careful diagnosis, emergency drainage when required, and definitive correction — including minimally invasive pyeloplasty — under the care of Dr. Aditya Sengar (Urologist). Our approach emphasises preservation of kidney function and fast recovery.
What causes PUJO?
PUJO may be congenital (the most common cause in children) or acquired. Common causes include an intrinsic narrowing of the junction, crossing blood vessels compressing the ureter (vascular PUJO), previous surgeries or inflammation causing scarring, stones, or tumours. Early evaluation helps decide the best treatment to protect kidney function.
Typical Symptoms & Signs
In children, PUJO may present with an abdominal mass, recurrent urinary infections, or poor growth. In older children and adults, symptoms include flank pain (colicky or dull), recurrent urinary tract infections, hematuria or incidentally detected hydronephrosis on imaging.
Diagnostic Tests We Use
Ultrasound is the first-line test to detect hydronephrosis. Functional assessment is done with nuclear renography (DTPA or MAG3) to quantify drainage and split renal function. CT urography or MR urography help evaluate anatomy and crossing vessels when necessary.
When is Emergency Drainage Needed?
If there is infected hydronephrosis (fever, sepsis) or if obstruction is causing rapidly worsening kidney function, temporary drainage with a percutaneous nephrostomy or internal stent is performed urgently prior to definitive repair.
Assessment for Surgery
Decision for surgery is based on symptoms, degree of obstruction, and relative kidney function on renogram. Even asymptomatic but poorly draining kidneys with falling function are considered for repair.
Treatment Options for PUJO
Our treatment plan is tailored to the cause, patient age and kidney function:
1. Pyeloplasty (Definitive Repair) — Gold-standard surgical correction where the narrowed segment is removed and the healthy ureter is reconnected to the renal pelvis. Approaches include:
• Open pyeloplasty — used in complex cases or where anatomy favours an open approach.
• Laparoscopic pyeloplasty — minimally invasive keyhole surgery with excellent success and faster recovery.
• Robotic pyeloplasty — offers precision suturing and ergonomics especially useful in children and complex reconstructions (availability dependent on centre resources).
2. Endopyelotomy / Endoscopic Options — Endoscopic incision or balloon dilatation of the narrowed segment may be considered in selected adult patients with short strictures, but success rates are generally lower than pyeloplasty.
3. Temporary Drainage — Percutaneous nephrostomy or ureteral stent for infected or high-pressure systems before definitive repair.
Our aim is to choose the least invasive effective option that preserves renal function long-term.
1. Pyeloplasty (Definitive Repair) — Gold-standard surgical correction where the narrowed segment is removed and the healthy ureter is reconnected to the renal pelvis. Approaches include:
• Open pyeloplasty — used in complex cases or where anatomy favours an open approach.
• Laparoscopic pyeloplasty — minimally invasive keyhole surgery with excellent success and faster recovery.
• Robotic pyeloplasty — offers precision suturing and ergonomics especially useful in children and complex reconstructions (availability dependent on centre resources).
2. Endopyelotomy / Endoscopic Options — Endoscopic incision or balloon dilatation of the narrowed segment may be considered in selected adult patients with short strictures, but success rates are generally lower than pyeloplasty.
3. Temporary Drainage — Percutaneous nephrostomy or ureteral stent for infected or high-pressure systems before definitive repair.
Our aim is to choose the least invasive effective option that preserves renal function long-term.
What to Expect: Surgery & Recovery
Pyeloplasty is usually performed under general anaesthesia. Minimally invasive approaches are typically day-care or short-stay procedures depending on age and comorbidities. A ureteral stent may be placed and removed after a few weeks. Postoperative follow-up includes imaging (ultrasound, and sometimes repeat renogram) to confirm unobstructed drainage and stable/improved kidney function. Most patients return to normal activities within 2–4 weeks after minimally invasive repair.
Why Choose Swastik Urology Clinic for PUJO Care?
Swastik Urology Clinic provides comprehensive PUJO care with attention to detail:
• Accurate Diagnosis
Precise assessment using ultrasound, renography and cross-sectional imaging to plan the correct intervention.
• Minimally Invasive Expertise
Experience in laparoscopic pyeloplasty provides high success rates with shorter hospital stay and quicker recovery.
• Paediatric & Adult Care
We manage PUJO across age groups — from antenatal hydronephrosis in infants to acquired obstructions in adults — coordinating with paediatricians and nephrologists when needed.
• Urgent Drainage & Support
Emergency drainage (nephrostomy) and infection management are available when required before definitive repair.
• Accurate Diagnosis
Precise assessment using ultrasound, renography and cross-sectional imaging to plan the correct intervention.
• Minimally Invasive Expertise
Experience in laparoscopic pyeloplasty provides high success rates with shorter hospital stay and quicker recovery.
• Paediatric & Adult Care
We manage PUJO across age groups — from antenatal hydronephrosis in infants to acquired obstructions in adults — coordinating with paediatricians and nephrologists when needed.
• Urgent Drainage & Support
Emergency drainage (nephrostomy) and infection management are available when required before definitive repair.
How is PUJO different in children and adults?
Congenital PUJO is common in infants and children and may be suspected on antenatal ultrasound. In adults, PUJO is often due to crossing vessels, scarring, stones or tumours. Evaluation and timing of surgery vary — children may need earlier intervention to protect renal growth, while adult management is individualized.
What tests confirm obstruction and kidney function?
Ultrasound shows hydronephrosis. A DTPA or MAG3 renogram is the standard functional test to demonstrate delayed drainage and to measure split renal function — crucial for deciding on surgery.
Is minimally invasive pyeloplasty effective?
Yes — laparoscopic and robotic pyeloplasty offer success rates comparable to open surgery with the advantages of smaller incisions, less pain and faster recovery when performed by experienced surgeons.
When should I consult a urologist for PUJO?
Consult a urologist if imaging shows hydronephrosis, you have recurrent flank pain, urinary infections, hematuria, or if kidney function is declining. Early specialist assessment helps protect kidney function and plan appropriate treatment.