Pyeloureteral junction syndrome: experience at the Douala General Hospital

Resumo

Background: Pyeloureteral junction syndrome (PUJS) is a frequent upper urinary tract malformation. We report the experience at Douala General Hospital (DGH) in diagnosing and managing PUJS.

Methods: This was a retrospective study from January 2015 to June 2025 (10 years) that included all adult and paediatric patients who underwent surgery for PUJS.

Results: During the study period, 18 cases of PUJS underwent surgery, of which 61.1% were men, with an average age of 34.1 years (range 4–72). The main presenting complaints were flank pain (83.34%) and recurrent urinary tract infections (16.67%), all evolving within five years before surgery. Ultrasound, coupled with a computed tomography (CT) scan, was performed to confirm the PUJS diagnosis. Anderson–Hynes open pyeloplasty was performed in all patients, followed by double-J stent placement spanning the anastomosis. In one case, the uncrossing of a lower polar vessel was done, followed by pyeloplasty. For the patient with bilateral PUJS, the most symptomatic side (left) was treated first and the other side was treated six months later. One patient had a nephrectomy for a type IV non-functional kidney. The renal compartment was drained with a negative pressure drain, and all drains were removed within 48–72 hours postoperatively. The average surgery time was 124 minutes (range 97–161), while the average hospital stay was five days. Postoperative outcomes were simple, with resolution of clinical and biological signs at six- and 12-month follow-up visits.

Conclusion: Done properly, Anderson–Hynes open pyeloplasty has a success rate of over 90% and remains the gold standard in settings where laparoscopy and robotics are not readily available.