Abstract
Hydronephrosis due to obstruction at the pelvi-ureteric junction is a relatively common condition, but there is still much conflict of opinion concerning the relative importance of the various aetiological factors involved. It is, therefore, not surprising that the abnormal radiological appearances have been subject to various interpretations. The correlation of pyelographic and operative findings is extremely difficult if the conventional posterior approach is used in the surgery of hydronephrosis, but recently we have changed to an anterior extraperitoneal approach and this has enabled the renal pelvis and upper ureter to be inspected in situ and has permitted a more accurate assessment of the various obstructing factors. This information has helped to elucidate the confusing radiological picture encountered with obstruction at the pelvi-ureteric junction and has shown the importance of the functional as well as the anatomical basis for the hindrance. Ostling (1942) has emphasised that congenital anomal...
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