Pelviureteric Junction Obstruction in Duplex System: Management and Review of Literature

Objective: Objective of this study was to review the management and outcome of 17 children with pelvi-ureteric junction obstruction (PUJO) in a duplex kidney. Materials and Methods: We analyzed our record from January 2000 to December 2011. A total of 258 pyeloplasty in a single system and 17 pyeloplasty in duplex system were performed during this period. Lower and upper pole moiety obstruction was seen in both complete and incomplete duplex systems. The duplex was suspected in ultrsonography (USG), renal scintigraphy and confirmed on magnetic resonance urography (MRU). Results: Ten children had upper moiety obstruction while seven had a lower moiety obstruction. Upper and lower pole obstructions were seen in both complete and incomplete duplex moiety. Eleven children underwent Anderson-Hynes pyeloplasty, three underwent ureteropyelostomy, and two underwent heminephrectomy while one underwent uretero-ureterostomy Conclusion: There are a multitude of surgical options to deal with PUJO in duplex system and management should be based on the pathological and functional anatomy and the experience of the surgeon.