Management of Ureteropelvic Junction Syndrome Caused by a Lower Polar Vessel Discovered Intraoperatively: A Case Report

Ureteropelvic junction syndrome (UPJS) is an obstruction of the upper urinary tract. It is the most common obstructive congenital uropathy in children and also frequently seen in adults. It is defined as a congenital or acquired obstruction between the renal pelvis and the ureter, leading to dilation of the upstream pyelocaliceal cavities with a normal-caliber downstream ureter, causing impaired urine transport from the pelvis to the ureter. The reference imaging examination remains the CT urography, combining arterial phase (to assess polar vessels) and delayed phase images, showing significant renal pelvis dilation, possibly associated with calyceal dilation, and a slender ureter. The gold standard treatment is open pyeloplasty using the Kuss-Anderson technique.