Condition
Pelviureteric junction (PUJ) obstruction
PUJ obstruction is a narrowing where the kidney meets the ureter. Modern keyhole and robotic pyeloplasty offer excellent long-term results and a rapid recovery.
Overview
What is this condition?
The pelviureteric junction (PUJ) is where the drainage system of the kidney narrows to form the ureter. A blockage here can slow urine flow, cause loin pain and — over time — reduce kidney function.
It may be present from birth or develop later in life. With modern imaging and reconstructive surgery, most patients achieve durable, symptom-free drainage.
Common symptoms
Symptoms to be aware of
Symptoms vary from person to person. Specialist assessment helps determine the underlying cause.
Loin pain
Especially after drinking fluids.
Nausea or vomiting
Blood in the urine
Recurrent urinary infections
Kidney stones on the affected side
Sometimes no symptoms at all
May be found incidentally on a scan.
Possible causes
What can cause it
Congenital narrowing
Most common cause — the narrowing has been present since birth.
Crossing blood vessels
An accessory renal artery can compress the PUJ from outside.
Stones or scarring
Previous stones, surgery or infection can cause acquired narrowing.
Many causes are benign and highly treatable. A structured consultant-led assessment is the fastest way to reach a clear diagnosis and a personalised plan.
When to seek medical advice
Some symptoms should always prompt prompt specialist review. Please seek urgent medical advice — through your GP, NHS 111 or A&E — if you notice any of the following.
- Severe loin pain
- Fever with loin pain (suggesting infected obstruction)
- Visible blood in the urine
- A rising creatinine or falling kidney function
- Recurrent kidney infections on the same side
Diagnosis
How the diagnosis is made
Diagnosis follows a clear, patient-centred pathway — often completed within one or two visits.
- 01
Medical history
Pattern of pain, prior imaging and infections.
- 02
Examination
Abdominal and flank examination.
- 03
Urine and blood tests
Kidney function and evidence of infection.
- 04
Ultrasound
First-line imaging showing dilatation of the kidney.
- 05
CT or MR urogram
Detailed anatomy and any crossing vessels.
- 06
Renogram
A nuclear medicine scan measuring drainage and split function.
Treatment options
Treatments tailored to you
Treatment is personalised through shared decision-making. Both conservative and procedural options are considered where appropriate.
Frequently asked questions
Your questions, answered
Why patients choose Mr Teleb
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NHS Consultant
Substantive Consultant Urologist at University Hospital of Wales.
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Most new patients are seen within a few days.
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Patient information
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FRCS (Urol)
Fellowship-trained consultant
5.0 patient rating
Verified private reviews
Seen within days
Same-week appointments
All major insurers
BUPA · AXA · Aviva · Vitality · WPA