the dilemma of ureterovesical junction obstruction

Background: ureterovesical junction obstruction (uvjo) is the result of an anatomic or a functional abnormality in the distal segment of the ureter. there are many types of uvjo, different in their cause, presentation, imaging characters, and prognosis. objectives: the aim of this study was to discuss the postoperative natural course and prognosis of patients undergoing standard approaches on the management of primary uvjo by one surgeon in a 10-year period starting from 2004. methods: from january 2004 to october 2013, 64 patients who underwent ureteral tapering and stenting ureteroneocystostomy for complicated primary uvjo participated in the study. results: the mean age of patients was 26 years (range: 11 months to 73 years). the mean hospital stay was 5 days (range: 4 to 7 days). the post-operative time was between 1 and 2 hours. double j stent was left in place for 4 weeks. post-operative follow-up was at least one year. no major complication was encountered, instead, a decrease in symptoms in all patients and an increase in renal function in 40 out of 64 (62.5%) patients were observed in the one-year follow-up of the diethylenetriaminepentaacetic acid (dtpa) renal scanning. only 3 patients had fever as a postoperative minor complication. conclusions: decision making in the treatment of uvjo is somewhat a dilemma. this condition is occasionally asymptomatic and uneventful, and may be detected accidentally during an unrelated work-up; nonetheless, it may also cause serious life threatening complications. surgical management in complicated casesmaybe a safe and viable treatment option both in children and in adults.