Pelviureteric Junction (PUJ) Obstruction London
The pelviureteric junction, known as the PUJ, is where the kidney joins the ureter, the tube that carries urine down to the bladder. If this area is narrowed or compressed, urine may not drain from the kidney as freely as it should. This is called PUJ obstruction.
PUJ obstruction can cause intermittent loin pain, recurrent infections, kidney stones or swelling of the kidney. It is important to assess both drainage and kidney function carefully, so that treatment can be recommended when it is needed.
What is PUJ obstruction?
Each kidney filters waste and excess fluid from the blood to make urine. Urine collects in a funnel-shaped area called the renal pelvis, then drains into the ureter and travels to the bladder.
PUJ obstruction happens when the junction between the renal pelvis and ureter is too narrow, or when it is compressed from outside the kidney. This can prevent urine draining normally, causing it to collect in the kidney. Over time, this can stretch the kidney. This swelling is known as hydronephrosis.
Many cases are present from birth, although symptoms may not appear until adulthood. The narrowing may be caused by an area of the junction that has not developed normally. In some people, a blood vessel crossing the ureter can affect drainage from the kidney.
A typical symptom is pain in the side or back, often called loin pain, which comes and goes. It may be more noticeable after drinking a large volume of fluid. Some people develop urine infections or kidney stones, while others find out about the condition only after a scan for another reason.
The key questions are whether drainage from the kidney is significantly affected and how well the kidney is functioning. Your consultant can arrange the appropriate tests to answer both.
Possible symptoms of PUJ obstruction
PUJ obstruction does not always cause symptoms. When it does, they can vary depending on the degree of blockage and its effect on the kidney.
Intermittent loin pain
A dull ache or pain in the side or lower back that may come and go. It can become more noticeable after drinking more fluid than usual.
Urine infections or kidney stones
Poor drainage can sometimes increase the likelihood of repeated urine infections or stones forming in the kidney.
A swollen kidney found on a scan
Some people have no obvious symptoms. The condition may be discovered when hydronephrosis is seen during an ultrasound, CT scan or other imaging test.
How we assess PUJ obstruction
Assessment is designed to establish whether there is a significant obstruction and to understand how the affected kidney is coping.
Ultrasound or CT scan
Imaging can show whether the kidney is swollen and help identify narrowing at the PUJ. It can also check for other potential causes of symptoms, such as kidney stones.
Renogram or drainage scan
A renogram is a specialist scan that assesses how urine drains from each kidney. It can also measure how much each kidney contributes to overall kidney function.
Blood and urine tests
Blood tests can help assess kidney function, while urine tests may check for infection, blood or other changes that need attention.
From assessment to treatment
Treatment depends on the degree of obstruction, the effect on kidney drainage and function, and whether you are experiencing symptoms such as pain, recurrent infections or kidney stones.
If the obstruction is mild, kidney function is stable and you have few or no symptoms, monitoring with follow-up scans may be appropriate. This allows your consultant to keep track of the kidney without recommending treatment unnecessarily.
Where there is a confirmed obstruction that is causing problems or affecting kidney function, surgery may be recommended to improve drainage and protect the kidney. Your consultant will explain the findings clearly and discuss the potential benefits, risks and alternatives in your individual situation.
Why choose The Forbury Clinic for PUJ obstruction treatment in London?
Assessment based on clear measurements
Imaging and drainage testing help assess kidney function and urine flow, so decisions are based on detailed findings.
Treatment when it is appropriate
Mild and stable cases may be monitored, while confirmed obstruction causing symptoms or affecting function can be treated.
Clear explanation of your options
Your consultant will explain what your scans show, whether treatment is needed and what each option may involve.
Consultant-led care in London
You will be assessed by a consultant urologist at The Forbury Clinic London, with self-referral welcome.
Frequently asked questions
Why does PUJ obstruction pain come and go?
Symptoms can vary because the kidney may struggle to drain when it produces more urine, for example after drinking a large amount of fluid. As pressure builds within the kidney, this can cause discomfort or pain that settles once drainage improves.
If I have had this since birth, why is it causing problems now?
Some people have a narrowing that causes few symptoms for many years. It may become more noticeable over time, be identified after a new symptom develops or be found incidentally during a scan. Assessment helps establish whether the obstruction is affecting kidney drainage or function now.
What is a pyeloplasty?
A pyeloplasty is an operation to repair the narrowed area between the kidney and ureter. The aim is to create a wider connection that allows urine to drain more freely from the kidney.
Will I need surgery?
Not always. If kidney function is stable and the obstruction is mild or not causing symptoms, monitoring may be appropriate. Surgery may be considered if there is significant blockage, ongoing pain, repeated infections, kidney stones or concern about kidney function.
Will my kidney function improve after treatment?
The aim of treatment is to improve drainage and help protect the function of the kidney. The effect on kidney function varies between individuals and depends on factors including the severity and duration of the obstruction. Your consultant will discuss what the test results mean in your case.
Get PUJ obstruction properly assessed
Intermittent loin pain, recurrent infections or a swollen kidney on a scan deserve clear answers. Our consultant urologists can arrange an assessment and discuss the appropriate next steps.
- AppointmentBook a consultation
- Reception0118 920 7055
- Location
The Forbury Clinic London, 45 Queen Anne St, London, W1G 9J
