Pelvi Ureteric Junction (PUJ) Obstruction Treatment in Andheri, Mumbai
If you have been told that your kidney is blocked, or if you are suffering from recurring flank pain, urinary infections, or kidney swelling — you could be dealing with a Pelvi Ureteric Junction (PUJ) Obstruction. It sounds complex, but with the right specialist and the right treatment, it is very manageable.
Dr. Ashish Gupta offers comprehensive PUJ Obstruction treatment in Andheri, Mumbai — from accurate diagnosis using advanced imaging to minimally invasive laparoscopic and robotic pyeloplasty, which is the gold standard surgical repair for this condition. The goal is always the same: remove the blockage, protect kidney function, and help you get back to living comfortably.
Meet Dr. Ashish Gupta – Expert Urologist in Andheri, Mumbai
Dr. Ashish Gupta
What is Pelvi Ureteric Junction (PUJ) Obstruction?
The Pelvi Ureteric Junction—also called the Ureteropelvic Junction (UPJ)—is the point where the renal pelvis (the funnel-shaped collecting part of the kidney) meets the ureter (the narrow tube that carries urine down to the bladder). In a healthy urinary system, urine produced by the kidney flows freely from the renal pelvis through the PUJ and down the ureter to the bladder.
PUJ obstruction occurs when this junction becomes narrowed, kinked, or externally compressed—slowing or completely blocking the flow of urine out of the kidney. When urine cannot drain properly, it backs up into the kidney, causing it to swell—a condition known as hydronephrosis. Over time, if left untreated, this pressure damages the kidney tissue and can lead to permanent loss of kidney function.
What are the Signs and Symptoms of PUJ Obstruction ?
Flank pain or loin pain — a dull or aching pain on one side of the back, between the ribs and hip; often the most prominent symptom
Pain that worsens after drinking large amounts of fluid, particularly alcohol — characteristic of intermittent PUJ obstruction (sometimes called 'Dietl's crisis')
Burning or frequent urination — indicating associated urinary infection
Recurrent kidney infections (pyelonephritis) that keep returning despite antibiotic treatment
How is PUJ Obstruction Diagnosed?
Dr. Ashish Gupta uses a thorough and systematic approach to diagnose bladder cancer accurately. The diagnostic process may include:
Medical History and Symptom Review
tThe doctor assesses flank pain, urinary infections, nausea, kidney stones, and previous urinary problems.
Physical Examination
The abdomen and kidney area are examined for tenderness, swelling, or signs of urinary obstruction.
Urine Test
A urine sample is checked for infection, blood, or other abnormalities linked to blocked urine drainage.
Blood Tests
Kidney function tests measure creatinine and other markers to determine whether the obstruction has affected the kidneys.
Kidney Ultrasound
Ultrasound images help detect hydronephrosis, which is swelling of the kidney caused by collected urine.
Diuretic Renal Scan –
A MAG3 or DTPA scan evaluates kidney function and measures how effectively urine drains into the ureter.
What Is PUJ Obstruction Staging?
PUJ obstruction does not have fixed stages like cancer. Its severity is commonly described according to the degree of hydronephrosis, kidney tissue changes, urine drainage, and renal function.
Grade 1 – Mild Hydronephrosis
There is slight widening of the renal pelvis, while the kidney calyces and kidney tissue remain normal.
Grade 2 – Mild to Moderate Hydronephrosis
The renal pelvis and a few calyces become enlarged, but the kidney tissue is still preserved.
Grade 3 – Moderate Hydronephrosis
The renal pelvis and all calyces are visibly dilated, although the kidney tissue usually remains reasonably maintained.
Grade 4 – Severe Hydronephrosis
Marked swelling of the kidney is present along with thinning of the kidney tissue, suggesting significant obstruction and possible loss of function.
Bladder Cancer Treatment in Andheri May Include
Regular Monitoring
Mild cases with stable kidney function may be observed through periodic ultrasound, urine tests, and renal scans.
Pain and Infection Management
Medicines may be prescribed to control discomfort and treat urinary infections associated with poor kidney drainage.
Ureteric Stent Placement
A temporary stent may be inserted to allow urine to pass from the kidney to the bladder and relieve obstruction.
Percutaneous Nephrostomy
A drainage tube may be placed directly into the kidney when urgent relief of severe blockage or infection is required.
Laparoscopic Pyeloplasty
The blocked PUJ segment is removed and the healthy ureter is reconnected to the kidney through small incisions.
Frequently Asked Questions About PUJ Obstruction
PUJ stands for Pelviureteric Junction—the connection point between your kidney’s collecting system and the tube that carries urine to your bladder. When this junction becomes narrowed or blocked, urine cannot drain out efficiently. It builds up inside the kidney, causing it to stretch and swell—a condition called hydronephrosis. Over time, this pressure damages the kidney’s filtering tissue.
Most patients are discharged from hospital within 2 to 3 days of laparoscopic pyeloplasty. A temporary internal ureteric stent (DJ stent) is left in the kidney after surgery and is removed cystoscopically (through a camera) under local anaesthesia after 4 to 6 weeks — a short, outpatient procedure. Most patients can return to desk work and light activities within 2 to 3 weeks. A follow-up renogram is typically performed at 3 to 6 months after surgery to confirm successful resolution of the obstruction.
Recurrence after pyeloplasty is uncommon — occurring in approximately 3 to 5% of cases. When it does recur, it is usually due to scar formation at the repair site during healing. Recurrent PUJ obstruction can often be managed with endopyelotomy (a minimally invasive incision technique) or, where necessary, a repeat pyeloplasty. Regular follow-up with ultrasound and renogram after surgery ensures that any recurrence is detected early and treated promptly.
Yes — PUJ Obstruction is in fact more commonly detected in children, often during prenatal ultrasound or in the first few years of life. In many cases, mild congenital hydronephrosis in infants resolves on its own without any treatment. However, progressive or severe cases require surgical correction. Pyeloplasty in children has excellent results and is considered very safe when performed by an experienced urologist. Dr. Ashish Gupta is experienced in managing both paediatric and adult PUJ obstruction.
Yes, untreated PUJ obstruction may cause persistent kidney swelling, repeated infections, kidney stones, and gradual loss of kidney function.
No, mild cases with stable kidney function may only need monitoring, while severe blockage, pain, infection, or reduced kidney function may require pyeloplasty.
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