Ureteropelvic junction obstruction (UPJO) is characterized by impaired flow of urine from the renal pelvis to the ureter. Untreated disease can result in renal impairment making effective management crucial. A combination of CT imaging and diuretic renography is typically used for diagnosis. CT is the investigation of choice for obtaining anatomical information about UPJO and can help to identify potential causes. Diuretic renography is best for providing functional information about UPJO. A variety of open and minimally invasive surgical techniques are available for treatment of UPJO. Traditionally open pyeloplasty has been the standard of care but minimally invasive surgical techniques have become increasingly popular. Endopyelotomy has a lower success rate than other modalities (42-90% depending on the approach), but is associated with reduced pain and shorter convalescence. Laparoscopic pyeloplasty and robot-assisted pyeloplasty have similar success rates to open pyeloplasty (>90%), with the additional advantages of significantly reduced morbidity and shorter convalescence. More long-term outcome data for minimally invasive surgical techniques are awaited.
as explicitly enjoying the situation, seeking connection with others and feeling content. From the ''broaden-and-build'' theory (Fredrickson 2001), we know that positive feelings, such as joy, love and contentment, are important for the development of personal resources and relationship-building skills, and therefore should be fostered.Second, our study revealed an important gender difference. Female students more often talked about their experiences than men did. Although most medical students are female (68%), we do have a substantial number of male students as well. Our findings pose the question if the needs of our male students are adequately met in an ongoing feminization of the curriculum and the medical workplace.In conclusion, this study reveals many positive responses to emotional clinical experiences. Important implications for medical education are that (a) we should help students recognize and use these positive experiences, (b) the nursing home seems to be particularly suited as a learning environment for medical students, fostering contentment and team spirit, and (c) educators should be aware of gender differences.
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