Ureteropelvic Junction (UPJ) Obstruction is a condition where there is a blockage or narrowing at the junction where the ureter (the tube that carries urine from the kidney to the bladder) meets the renal pelvis (the funnel-like part of the kidney that collects urine). This obstruction can impede the normal flow of urine from the kidney to the bladder, leading to a buildup of urine in the kidney, a condition known as hydronephrosis.
Congenital (Present at Birth): Most commonly, UPJ obstruction is due to a congenital defect, such as a narrowing or abnormal development of the ureter at the junction.
Acquired: Less commonly, UPJ obstruction can develop later in life due to factors such as:
Kidney stones
Scar tissue from previous surgeries or infections
Tumors
Trauma to the area
In Infants:
Abdominal mass
Failure to thrive
Urinary tract infections (UTIs)
In Older Children and Adults:
Flank or abdominal pain (often intermittent and worsened by drinking large amounts of fluid)
Hematuria (blood in the urine)
UTIs
Nausea and vomiting (especially during episodes of pain)
Hypertension (high blood pressure) in some cases
Ultrasound: Often the first imaging test done, which can show hydronephrosis (swelling of the kidney due to urine buildup).
CT Scan or MRI: These imaging studies can provide more detailed images of the urinary tract and help identify the exact location and cause of the obstruction.
Renal Scan (Diuretic Renography): This test measures kidney function and the degree of obstruction by tracking the flow of a radioactive tracer through the urinary system.
Intravenous Pyelogram (IVP): An X-ray test that uses a contrast dye to visualize the urinary tract.
Observation: In mild cases, especially in infants, the condition may resolve on its own, and regular monitoring may be all that is needed.
Surgery: In more severe cases, surgery may be required to remove the obstruction. The most common surgical procedure is called a pyeloplasty, which involves removing the narrowed or obstructed segment of the ureter and reattaching the healthy portion to the renal pelvis.
Minimally Invasive Procedures: In some cases, less invasive techniques such as endoscopic surgery or laparoscopic pyeloplasty may be used.
The prognosis for UPJ obstruction is generally good, especially if the condition is diagnosed and treated early. Most patients experience significant improvement in kidney function and relief of symptoms after treatment.
If you suspect a UPJ obstruction or have been diagnosed with one, it’s important to follow up with a urologist or nephrologist for appropriate management and treatment.
