URETEROPELVIC JUNCTION OBSTRUCTION

¹ KANSAS CITY, MISSOURI

1. Thirty-five patients with renal pelvic dilatation resembling ureteropelvic junction obstruction have been studied to determine the pathogenesis.

2. Twenty-nine of the patients had nonobstructive and 6 had obstructive dilatation.

3. A classification of the types of renal pelvic dilatation is presented which has etiologic, therapeutic and prognostic signicance.

4. The nonobstructive variety is a manifestation of generalized renal collecting system dilatation in which the pelvis, if considered alone, exhibits features typical of ureteropelvic junction obstruction.

5. Ureteral dilatation, tortuosity and kinking with extrinsic and intrinsic fibrosis due to infection and reflux are the pathogenetic factors involved.

6. Roentgen and surgical findings indicate that the pathogenesis is the same in the nonobstructive and secondary obstructive types of renal pelvic dilatation.

7. Primary obstructive ureteropelvic dilatation is rare and it is believed that renal pelvic dilatation is not always obstructive or congenital.

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