Pelviureteric Junction (PUJ) Obstruction is one of the causes of severe hydronephrosis. When surgery is required to resolve the blockage of PUJ obstruction that caused the hydronephrosis, open or keyhole surgery are equally successful. Laparoscopic (keyhole) surgery is advisable when it is important to reduce the size or noticeability of the scar and is generally preferable in children over 2 years of age. Open surgery with placement of DJ stent however is the least invasive for babies and also for older children whose kidneys are hugely dilated.
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