Detection of crossing vessels with ureteropelvic junction obstruction (UPJO) by computed tomography urography (CTU)

Objective: To assess the use of computed tomography urography (CTU) for the detection of crossing vessels with ureteropelvic junction obstruction (UPJO). Methods: Twenty-one patients aged 18 to 62 yr (mean age, 32) who had been diagnosed with a UPJO were included retrospectively. Of the cases 8 were on the left and 13 on the right side. CTU was performed in every patient and intravenous urography was performed in 16 cases with retrograde ureteropyelography performed in 6 cases. Results: Twenty of 21 patients (95.2%) demonstrated crossing vessels at CTU examination. Fourteen of 16 patients demonstrated hydronephrosis in IVU examination with no patient detected the etiology. There were 20 arteries and one vein detected. All patients were confirmed crossing vessels with operation. Twelve cases were performed with open operation of vessel devascularization with 5 cases combined with pyeloplasty. Eight cases were performed with laparoscopic procedures of vessel devascularization with 2 cases combined with pyeloplasty. Nephrectomy was performed in 1 case. Conclusions: CTU can be recommended as first-line imaging modality for the detection of crossing vessels in patients with UPJO.