Question:hard
Pelviureteric obstruction on the left side in a 33 year old male who presents with fever and infection. All the following are correct EXCEPT
Pelviureteric obstruction on the left side in a 33 year old male who presents with fever and infection. All the following are correct EXCEPT
Show Hint
Recall whether an intrinsic narrow segment or an outside vessel is the more common cause of PUJ obstruction.
Updated On: Jul 8, 2026
- Dismembered pyeloplasty is the treatment of choice
- Endoscopic pyeloplasty is contraindicated
- Most common cause is an aberrant vessel
- Tuberculosis can be a cause
Show Solution
The Correct Option is C
Solution and Explanation
Step 1: Understanding the Question:
A young man has a blocked pelviureteric junction on the left with fever and infection, and we must find the one statement among four that is not correct.
Step 2: Key Formula or Approach:
Check each statement against two known facts of PUJ obstruction, the standard operation used, and the standard list of causes, where an intrinsic segment is far more common than an outside vessel.
Step 3: Detailed Explanation:
Dismembered pyeloplasty, described by Anderson and Hynes, removes the narrow segment and rejoins the pelvis to the ureter with a wide new opening. It remains the standard operation for PUJ obstruction, so this claim holds up.
Endoscopic pyelotomy cuts the narrow area from within using a scope, without removing it. This technique needs a clean field to heal properly, so it is avoided when the kidney is actively infected, exactly the situation described here. This claim also holds up.
Tuberculosis is a known cause of secondary PUJ narrowing, since healing of a tuberculous ulcer in the urinary tract leaves behind scar tissue that can block the junction. This claim holds up too.
That leaves the statement about an aberrant vessel being the most common cause. In fact, most cases of PUJ obstruction, especially the congenital ones, come from an intrinsic segment of the ureter near the pelvis that cannot contract properly and push urine along. A crossing vessel pressing on the outside of the junction is a real but less common cause. So calling it the most common cause does not match the facts.
Step 4: Final Answer:
The statement that is not correct is that an aberrant vessel is the most common cause of PUJ obstruction, because an intrinsic aperistaltic segment is the more common cause.
\[ \boxed{\text{Most common cause is an aberrant vessel - INCORRECT statement}} \]
A young man has a blocked pelviureteric junction on the left with fever and infection, and we must find the one statement among four that is not correct.
Step 2: Key Formula or Approach:
Check each statement against two known facts of PUJ obstruction, the standard operation used, and the standard list of causes, where an intrinsic segment is far more common than an outside vessel.
Step 3: Detailed Explanation:
Dismembered pyeloplasty, described by Anderson and Hynes, removes the narrow segment and rejoins the pelvis to the ureter with a wide new opening. It remains the standard operation for PUJ obstruction, so this claim holds up.
Endoscopic pyelotomy cuts the narrow area from within using a scope, without removing it. This technique needs a clean field to heal properly, so it is avoided when the kidney is actively infected, exactly the situation described here. This claim also holds up.
Tuberculosis is a known cause of secondary PUJ narrowing, since healing of a tuberculous ulcer in the urinary tract leaves behind scar tissue that can block the junction. This claim holds up too.
That leaves the statement about an aberrant vessel being the most common cause. In fact, most cases of PUJ obstruction, especially the congenital ones, come from an intrinsic segment of the ureter near the pelvis that cannot contract properly and push urine along. A crossing vessel pressing on the outside of the junction is a real but less common cause. So calling it the most common cause does not match the facts.
Step 4: Final Answer:
The statement that is not correct is that an aberrant vessel is the most common cause of PUJ obstruction, because an intrinsic aperistaltic segment is the more common cause.
\[ \boxed{\text{Most common cause is an aberrant vessel - INCORRECT statement}} \]
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