O'Sullivan Niall J, Anderson Steven
Department of Urology, Tallaght University Hospital, Dublin, Ireland.
Department of Urology, Beaumont Hospital, Dublin, Ireland.
Curr Urol. 2023 Jun;17(2):86-91. doi: 10.1097/CU9.0000000000000154. Epub 2022 Sep 28.
Pelviureteric junction obstruction (PUJO) is a common urological disorder that can present at any stage of life. The underlying etiology in children has been well studied; however, a gap exists in the literature for the adult population. Herein, we performed a systematic review of the literature to evaluate the current evidence on the underlying etiologies of adult patients presenting with PUJO.
Four electronic databases were searched for relevant studies assessing the underlying etiologies of pelviureteric junction obstruction in adults. Studies were assessed for eligibility based on predefined inclusion and exclusion criteria, and a critical appraisal of methodological quality and risk of bias was performed. Finally, qualitative and quantitative data analyses were performed.
Twelve studies comprising a total of 513 patients with radiologically confirmed PUJO met the inclusion criteria and were included in our analysis. The most common finding was crossing vessels, which were observed in 50.5% of patients, followed by intrinsic ureteral stenosis (27.1%), adhesions (15.3%), and high insertion of the ureter (10.1%).
The underlying etiologies of PUJO in adults remain unclear. This study indicated that obstruction secondary to crossing vessels is the most common cause of obstruction in adults and occurs more frequently than in the pediatric population.
肾盂输尿管连接部梗阻（PUJO）是一种常见的泌尿系统疾病，可出现在生命的任何阶段。儿童患者的潜在病因已得到充分研究；然而，针对成人患者的文献存在空白。在此，我们对文献进行了系统回顾，以评估目前关于成人PUJO潜在病因的证据。
检索四个电子数据库，查找评估成人肾盂输尿管连接部梗阻潜在病因的相关研究。根据预先定义的纳入和排除标准评估研究的 eligibility，对方法学质量和偏倚风险进行批判性评价。最后，进行定性和定量数据分析。
12项研究共纳入513例经影像学证实为PUJO的患者，符合纳入标准并纳入我们的分析。最常见的发现是交叉血管，在50.5%的患者中观察到，其次是输尿管固有狭窄（27.1%）、粘连（15.3%）和输尿管高位插入（10.1%）。
成人PUJO的潜在病因仍不清楚。本研究表明，交叉血管继发梗阻是成人梗阻的最常见原因，且比儿童人群更频繁发生。
