A Narrative Review of Contemporary Challenges and Controversies in the Management of Congenital Pelvi-Ureteric Junction Obstruction (PUJO)

Pelvi-ureteric junction obstruction (PUJO/UPJO) is a relatively common presentation which may be identified at any age. The detection of this condition has grown exponentially with the widespread increase of imaging. This new surge in detection presents a unique challenge to the treating clinician to determine the optimal strategy for evaluation and intervention. The challenge is balancing early intervention whilst minimizing overtreatment. We present a narrative review of existing evidence on management of PUJO from detection, evaluation pathway, intervention, follow-up and management of complications with special emphasis on technical nuances on surgical management of PUJO for the practicing urologist.