Treatment of pelviureteric junction (PUJ) stricture by urologist Sergey Nikolaevich Glushchenko in the city of Dnipro

Patients present with difficulty urinating, lower back pain, frequent urges to urinate, or recurrent cystitis.

The doctor conducts a detailed clinical examination, analyzes the symptoms and medical history, and, if necessary, orders additional tests to accurately assess the condition of the pelvis-ureter segment.

The patient receives a clear and understandable action plan: what to do at the current moment, which tests to undergo, and how to monitor changes in their condition over time.

Special attention is given to precise differential diagnosis of the causes and dynamic observation, which helps to timely adjust treatment and prevent complications.

When to See a Doctor

If you experience difficulty with urine flow and possible dysfunction of the ureters, it is important to assess your condition promptly. You should make an appointment with a urologist if, while being treated for a pelviureteric junction obstruction, you notice:

• A constant feeling of heaviness or pain in the lower back
• Occasional sharp pain in the kidney area
• Frequent urges to urinate, even with little urine output
• Difficulty or pain during urination
• A sensation of incomplete bladder emptying
• Recurring urinary tract infections
• Worsening of symptoms when changing therapy or after an infection
• Symptoms that interfere with work or sleep
• A condition that recurs or progressively worsens
• Lack of improvement after self-care attempts
• The need to clarify diagnosis and monitor treatment
• The appearance of new or unusual complaints during the course of the illness

If you notice several of these symptoms, it is advisable to discuss them with a doctor. This will help determine the next steps and select the most appropriate treatment approach for your specific case. Do not delay if symptoms recur or worsen.

Emergencies or When to See a Doctor Immediately

• Sudden and severe worsening of condition with sharp pain in the lower back
• Onset of intense increasing pain and significant discomfort during urination
• Combination of high fever with chills and pain in the kidney area
• Sudden blockage of urine flow accompanied by severe abdominal tension
• Sudden appearance of swelling and significant deterioration of overall well-being

If you experience these symptoms, do not wait for a scheduled appointment. Instead, use the home doctor visit service to receive the necessary urgent care promptly.

Causes and Risk Factors of Ureteropelvic Junction Stricture

This section helps to understand the underlying causes of the problem and the factors that influence the likelihood of its occurrence or progression. It is important to remember that an accurate determination of causes requires a physician’s evaluation and additional examinations.

Main Causes / Mechanisms (Briefly)

• Chronic inflammations in the kidneys and ureters, which can lead to tissue scarring
• Injuries or damage to the ureters after surgeries or medical procedures
• Obstructions caused by calculi (stones), leading to impaired urine flow
• Congenital changes or anatomical anomalies of the ureters
• Recurrent urinary tract infections causing narrowing of the lumen

Risk Factors

• Age over 40 years, when the likelihood of changes in the urinary tract is higher
• History of urolithiasis (kidney stones)
• Previous surgical interventions on kidneys or ureters
• Frequent or inadequately treated urinary tract infections
• Trauma to the lumbar or abdominal area
• Comorbid chronic diseases that reduce immunity
• Urodynamic disorders associated with other urological conditions
• Hereditary predisposition to urinary system pathologies

Reversible Causes to Rule Out

• Acute infectious processes requiring treatment
• Obstruction caused by passing stones, which may temporarily narrow the lumen
• Inflammations responsive to therapy that reduce narrowing

Ureteropelvic junction stricture requires a comprehensive approach to identify causes and assess risk factors in order to select appropriate treatment and monitor disease progression.

Diagnosis

The diagnosis of pelviureteric junction (PUJ) stricture is aimed at identifying the causes of impaired urine outflow and assessing the extent of damage. The physician gathers detailed information to understand the symptoms and select the necessary examinations.

Diagnostic Approach

• Taking medical history, including clarification of complaints, past medical history, and previous interventions
• Physical examination to assess overall condition and identify signs of kidney and urinary tract dysfunction
• Ordering basic laboratory tests as indicated
• Conducting instrumental studies as needed to determine the location and degree of narrowing
• Evaluating results, forming a preliminary conclusion, and planning further examination and treatment

Typical Examinations as Indicated

If necessary, the diagnostic process may include:

• Ultrasound of the kidneys and urinary tract to assess patency and tissue condition
• Intravenous urography or CT urography for detailed visualization of the ureteral anatomy
• Urinalysis and blood tests to detect inflammatory processes or impaired kidney function
• Endoscopic studies if clarification of intraluminal ureteral changes is required

What to Bring to Your Appointment

• Results of previous examinations and tests
• Medical records regarding past surgeries or illnesses
• List of medications you are currently taking
• Symptom diary or description of any changes in your condition

Accurate diagnosis of pelviureteric junction stricture requires a comprehensive approach and step-by-step assessment to develop an optimal treatment plan.

Treatment

Treatment of pelvi-ureteric junction (PUJ) stricture is aimed at restoring normal urine flow and reducing symptoms. The therapy plan is tailored individually, taking into account the specifics of the condition, examination results, and indications.

Therapy Goals

• Reduce symptoms and discomfort associated with impaired urine flow
• Correct the causes leading to ureteral narrowing
• Improve kidney function and the overall condition of the patient
• Prevent complications and recurrent damage

Main Treatment Approaches

• May include medication management to reduce inflammation and improve tissue condition
• Non-pharmacological methods aimed at restoring patency and supporting function are possible
• Surgical or endoscopic interventions are applied as indicated to eliminate the stricture
• Therapy is always individualized and depends on diagnostic results and organ burden
• The treatment plan is adjusted based on the body's response and symptom dynamics

What the Doctor Does

• Selects and adjusts treatment considering comorbidities and individual characteristics
• Evaluates possible side effects and makes changes in therapy if necessary
• Explains effectiveness criteria and what to expect during treatment
• Coordinates monitoring with other specialists when a multidisciplinary approach is required

What to Expect: Planning and Monitoring

• The doctor assesses the symptom dynamics and kidney function during treatment approximately
• The plan may include regular examinations to monitor the condition
• If there is no effect or new symptoms appear, therapy may be adjusted
• Follow-up visits are scheduled based on the individual situation and treatment specifics

For detailed information about treatment options, you can consult with Dr. Sergey Nikolaevich Glushchenko.

Prevention

Prevention is important for reducing the risk of development and progression of pelvi-ureteric junction (PUJ) stricture. The prevention plan is tailored individually, taking into account health characteristics and risk factors.

Main primary prevention measures

• Monitoring and timely treatment of urinary tract infections
• Avoiding injuries and trauma to the lower back and abdominal area
• Supporting kidney health through regular check-ups as indicated
• Managing concomitant diseases affecting kidney and urinary tract function
• Prompt consultation with a doctor when symptoms of difficult urination appear

Screening and secondary prevention / regular monitoring

• Regular monitoring of kidney and urinary tract condition as per doctor's recommendations
• Screening for urodynamic disturbances when indicated
• Observation to assess treatment effectiveness and prevent complications
• Discussing with a doctor the optimal schedule for examinations and check-ups

Practical advice

• Maintain adequate fluid intake
• Discuss possible therapy adjustments with your doctor when dealing with concomitant conditions
• Avoid factors that can cause inflammation and infections
• Maintain moderate physical activity according to your health status
• Follow healthy lifestyle recommendations to strengthen immunity

Preventive measures for pelvi-ureteric junction stricture help control the condition and reduce the risk of complications but require regular medical monitoring and assessment.

Important to Know

Treatment of ureteropelvic junction (UPJ) obstruction using endoscopic methods requires careful evaluation of the condition and an accurate understanding of the cause of the narrowing. Early consultation helps to select the most effective strategy and reduces the risk of complications. Sometimes, dynamic monitoring with adjustment of the treatment plan according to changes is necessary. General factors such as stress, physical load, quality of sleep, and comorbidities can influence the course of the condition. Self-medication in such cases may obscure the true picture, cause side effects, and delay the start of proper therapy.

• It is important to identify the cause of the narrowing, not just alleviate symptoms
• Early assessment reduces the risk of progression and complications
• The treatment plan may be adjusted as symptoms or examination results change
• Lifestyle factors and comorbidities affect the disease course
• Self-directed treatment choices can complicate accurate diagnosis
• Endoscopic treatment is one of the minimally invasive options to relieve the narrowing
• A comprehensive approach helps preserve kidney function and improve quality of life

For more detailed information, we recommend reviewing the general page on urinary tract diseases and treatment methods. If you have any questions, it is important to consult a physician for a thorough examination and ongoing supportive care.

Self-care Before the Appointment: What You Can and Cannot Do

Before seeing a doctor for urinary tract issues, it is important to follow safe measures to avoid worsening your condition or distorting the picture of the illness. If your condition deteriorates, immediately seek help from Dr. Sergey Nikolaevich Glushchenko.

What You Can Do Before the Appointment

• Write down when and how the symptoms started, including circumstances and what worsens or alleviates the condition
• Bring a list of medications you are taking so the doctor can consider them during evaluation
• Measure and record basic parameters: body temperature, blood pressure, and pulse (if you know how)
• Keep a symptom diary, noting the intensity and timing of complaints
• Reduce physical activity and ensure rest to minimize additional strain
• Drink enough water if there is a risk of dehydration or if you have a fever
• Monitor your overall condition and promptly note any changes

What You Should Not Do Before the Appointment

• Do not stop regularly taken medications without consulting a doctor
• Do not start taking new medications or remedies simultaneously without a specialist’s recommendation
• Do not use unverified folk remedies promising quick effects
• Do not try to interpret test results or imaging on your own
• Do not delay seeking medical help if symptoms worsen or new pain appears
• Do not change your treatment regimen or diet without doctor’s approval
• Do not use strong painkillers or other medications without recommendation and supervision

If signs of deterioration or emergency symptoms appear, immediately contact Dr. Sergey Nikolaevich Glushchenko.

How I Can Help as a Doctor in the Endoscopic Treatment of Ureteropelvic Junction Stricture

During a consultation on the treatment of ureteropelvic junction (UPJ) stricture, I can assist you in the following ways: I will thoroughly review your symptoms and medical history to identify possible causes of the problem.

• Assess the severity of symptoms and risk factors influencing the disease course
• Review current medications and evaluate tolerance to ongoing or prescribed treatments
• Develop a plan for further steps, including necessary examinations, treatment, and monitoring
• Consider comorbidities and concomitant medications to choose the most appropriate therapy
• Provide recommendations on lifestyle and daily routines relevant to your case
• Discuss criteria for treatment effectiveness and set up a monitoring plan to track progress promptly
• Perform an initial diagnostic assessment to determine causes and rule out possible complications
• Choose a suitable treatment and management strategy considering disease stages and potential adjustments
• Help modify the treatment plan if the effect is insufficient or side effects occur

Every decision is tailored individually, taking into account your unique characteristics and condition. The consultation aims for a comprehensive approach so that you receive a clear plan of action and support throughout all stages of treatment.

What questions can be addressed to a doctor regarding the endoscopic treatment of pelvi-ureteric junction strictures?

During a consultation about the treatment of pelvi-ureteric junction (PUJ) strictures, you can discuss the following issues with Sergey Nikolaevich Glushchenko:

• Difficulty or pain during urination
• Pain in the lower back or flanks related to the urinary system
• Frequent urges to urinate with small volumes of urine
• Recurrent urinary tract infections or inflammations
• Impaired urine flow and narrowing of the urinary channels (strictures)
• Situations when symptoms worsen or recur
• Lack of improvement from previously prescribed treatment
• Need for a second opinion regarding diagnosis and therapy

In cases of severe pain, high fever with chills, or sudden worsening of condition — urgent medical attention is required; do not wait for a scheduled appointment.

Questions you can discuss during the consultation:

• What is happening to me and what could this be?
• Why have the symptoms appeared at this particular time?
• How can I be sure the symptoms are due to ureteral stricture and not another problem?
• What examinations are necessary specifically for my case?
• Which tests or investigations are mandatory, and which can be declined?
• How to properly prepare for examinations and the doctor's appointment?
• What treatment options are available for my condition?
• Is it possible to completely resolve this condition, or will long-term monitoring be required?
• Why is the prescribed treatment not helping, and what should be done next?
• Is it possible to avoid surgery or invasive procedures?
• How long does treatment usually take, and how often should follow-ups be done?
• What signs indicate improvement or worsening of the condition?
• What should I do if symptoms suddenly worsen or there is an exacerbation?

Consulting a doctor about pelvi-ureteric junction strictures gives you the opportunity to thoroughly discuss your concerns and receive recommendations for examinations and treatment. The priority is safety and timely resolution of issues; if necessary, the doctor will refer you for additional tests or to other specialists.

How the Consultation Proceeds

A consultation with the doctor involves a careful review of your complaints and symptoms, an assessment of the condition of the ureters and kidneys, as well as the development of a plan for further actions. The scope and necessity of examinations are determined individually, based on indications. During one appointment, you can receive a preliminary assessment of your condition and recommendations for next steps, without a promise of an exact diagnosis.

1. Clarification of complaints and visit purpose — the doctor finds out what exactly is bothering you, when the symptoms appeared, and how they affect your life.
2. Collection of medical history and risk factors — previous illnesses, possible injuries, and other important details are discussed.
3. Review of previous examinations and treatments — the doctor will study any available tests, images, and prescriptions; it is recommended to bring them with you.
4. Examination and tests as indicated — a general assessment is conducted, and if necessary, safe specialized diagnostic methods are prescribed.
5. Preliminary conclusion — the doctor will explain the likely causes and the importance of excluding serious conditions without making an online diagnosis.
6. Examination plan — recommendations may include kidney ultrasound, CT urography, urine and blood tests, or other investigations as indicated.
7. Discussion of treatment or management plan — general therapy principles aimed at improving your condition are explained.
8. Follow-up and further steps — timing for a repeat visit and indications for unscheduled consultations are determined.

If this is your first visit, the main focus is on clarifying symptoms and searching for possible causes. If previous treatment was ineffective, the doctor will concentrate on analyzing the reasons for the lack of effect and adjusting the therapy plan.

Preparation for the Appointment

This checklist will help you prepare for your urologist appointment regarding the treatment of pelvi-ureteric junction (PUJ) stricture and will facilitate a quicker diagnosis and treatment plan. It is important to follow all recommendations for a more effective visit.

• Bring a list of all current medications, including names, dosages, and schedules
• Bring results of previous examinations: kidney ultrasound, CT urography, urine and blood tests
• Write down your main complaints: when symptoms began, what worsens or improves your condition
• Do not stop taking prescribed medications without consulting your doctor
• If instructed in advance, come fasting — do not eat or drink for 8–12 hours (unless otherwise recommended, confirm when booking)
• If possible, bring discharge summaries or medical records related to past surgeries and other illnesses
• Prepare a list of questions you want to discuss with the doctor
• Avoid wearing makeup before the appointment if mentioned when you made the appointment (as indicated)
• If you have doubts about preparation, clarify the details with the reception when booking

If you are unsure about any of the points or have questions regarding medications, it is best to clarify in advance and not change your treatment on your own.

About the Doctor

Sergey Nikolaevich Glushchenko is a first-category surgeon-urologist with 20 years of experience. He specializes in treating patients with pelvi-ureteric junction strictures, working with both primary cases and chronic conditions, including those where previous treatments have been unsuccessful.

The doctor places special emphasis on differential diagnosis of causes and dynamic monitoring to timely adjust the treatment strategy. Thanks to extensive experience in endoscopic techniques and urological surgery, he provides a comprehensive approach to patient issues.

During the consultation, you will receive a clear analysis of your situation and a plan for the next steps, tailored to your individual needs.

Why Patients Choose Dr. Sergey Nikolaevich Glushchenko

When treating ureteropelvic junction (UPJ) obstruction, a comprehensive and attentive approach to assessing the patient’s condition is crucial. Sergey Nikolaevich places special emphasis on identifying the causes of the disease and analyzing complex clinical cases, including those where traditional treatments have failed. He takes into account all comorbidities and prescribed medications to ensure maximum safety of the therapy. Patients appreciate the clear explanation of the treatment plan and effectiveness criteria, as well as continuous monitoring of progress with adjustments to the therapy when necessary. This approach allows for a consistently different way of addressing the problem and supporting the patient at every stage.

• Clear treatment plan with defined stages and monitoring timelines for the patient’s convenience
• Examinations based on indications, without unnecessary procedures, saving the patient’s time and effort
• Consideration of comorbidities and medications to reduce risks and ensure therapy compatibility
• Monitoring of symptom changes and timely therapy adjustments if the effect is insufficient
• Review of previous prescriptions and drug tolerance to find the optimal solution
• Emphasis on differential diagnosis to accurately determine the cause and exclude complications
• Ongoing management with regular follow-up and treatment adaptation to changes in condition
• Support in complex cases and situations requiring a second opinion

Patients consulting Sergey Nikolaevich receive not only competent medical care but also a clear, structured treatment process. This approach reduces uncertainty and helps patients understand what is happening to their body and what to expect next.

Clinical Cases

Initial presentation with difficulty urinating

A middle-aged patient presented with complaints of intermittent lower back pain and difficulties during urination. Recurrent symptoms and possible inflammatory processes requiring thorough exclusion of complications were important considerations. The physician conducted a comprehensive examination, including necessary imaging and laboratory tests, to clarify the causes of ureteral narrowing. Over time, a reduction in symptoms and stabilization of the condition were noted within several weeks after initiating corrective measures. The further plan included regular monitoring and assessment of treatment effectiveness to control potential changes.

Adjustment of treatment strategy in the absence of effect

An elderly female patient reported that previously prescribed treatment did not improve symptoms of urinary outflow obstruction and pain. It was important to reassess the diagnosis and review the medication history for tolerance and side effects. Additional examinations were prescribed, and the therapeutic approach was modified based on new data. Ultimately, stabilization of the condition and a reduction in the frequency of discomfort episodes were observed. To maintain the result, ongoing dynamic management and timely adjustments of the plan as needed were ensured.

Chronic course with comorbidities

A young patient with a long history of urinary disorders and diagnosed concomitant urological problems sought consultation. Particular attention was paid to accounting for all accompanying factors and medications to avoid adverse interactions. The physician developed a more tailored diagnostic and treatment plan focused on gradual functional improvement. Follow-up visits showed improved quality of life and reduced symptom severity with continued regular monitoring.

Exacerbation of symptoms and prevention plan

A middle-aged patient visited the clinic with a sharp increase in pain and frequent urination. The urgent need was to exclude complications quickly and select safe measures to control symptoms. The doctor promptly adjusted the diagnostic plan and prescribed a supportive course, as well as developed recommendations for preventing recurrent exacerbations. Subsequent visits demonstrated positive dynamics and maintenance of condition control.

Complex case requiring second opinion and comprehensive approach

An elderly patient with an ambiguous clinical picture sought a second opinion after unsuccessful treatment attempts. The physician thoroughly reviewed previous data, broadened the diagnostic evaluation, and proposed a comprehensive management strategy. The patient was informed about the necessity of gradual observation and outcome assessment. Symptom improvement corresponded with the adequacy of the chosen approach. Regular monitoring and treatment adjustments continue based on follow-up examinations.

In all cases, the key factors were systematic identification of causes, exclusion of dangerous complications, and selection of therapy tailored to the individual patient’s characteristics. This approach allows disease control and quality of life improvement without undue burden and risk.

How long does a consultation last?

A consultation usually takes between 30 and 60 minutes. Please confirm the exact duration when booking.

How should I prepare for the appointment?

It is recommended to write down your symptoms, their duration and characteristics, as well as prepare any questions for the doctor.

What should I bring to the appointment?

Bring the results of previous examinations, scans, medical records, and a list of medications you are currently taking.

Do I need to come on an empty stomach?

Usually not, unless otherwise specified when booking.

How many visits are usually required?

The number of visits depends on the situation and the chosen treatment plan; sometimes a few visits are sufficient.

When can I expect to see the first results of treatment?

Initial changes are evaluated individually and depend on the chosen therapy.

What should I do if my condition worsens before the appointment?

If your condition worsens or you experience severe pain, high fever, or other alarming symptoms, you should urgently contact a doctor.

Can I continue my current medications during treatment?

Discuss your medications with your doctor. Do not change or stop them on your own before consultation.

Is it possible to have an online consultation?

Yes, online consultations are available. Please check the conditions when booking.

Can I come with already completed tests?

Yes, bring all available results for comprehensive analysis.

Do I need to come for follow-up visits and how often?

Follow-up visits are scheduled as needed based on your condition’s progress.

Can I get a second opinion?

Yes, the doctor is willing to review your results and discuss a second opinion.

What should I do if symptoms return after improvement?

If symptoms recur, it is advisable to make an appointment for a follow-up visit as soon as possible.

What tests are most commonly prescribed?

The list of tests is determined individually based on the doctor’s indications.

Can I refuse tests?

You should discuss this with your doctor, who will explain the necessity of each examination.

What will be discussed at the first consultation?

The doctor will collect information about your complaints, medical history, and decide on the further treatment approach.

Can I come without a referral?

Yes, you can book an appointment directly without a referral.

What should I do if there is not enough time for a full appointment?

It is recommended to schedule a separate appointment for a detailed consultation or check the possibility of an online consultation.