Reflux induced pelvi-ureteric obstruction.

The phenomenon of pelvi-ureteric obstruction which is induced by vesico-ureteric reflux is well documented but ill understood. The radiographic findings can be impressive to an extent that obstruction is probably often over-diagnosed. Before considering a pyeloplasty it is essential to confirm the true obstructive nature of the problem. Where the urogram is not suggestive of an obstruction a re-implantation of the ureter will usually stop the gross pelvic dilatation. It is suggested that the obstruction is at least partially an active process.