The ureteropelvic junction is located where the pelvis of the kidney meets the ureter (the tube that drains urine into the bladder). The term ureteropelvic junction (UPJ) obstruction describes a blockage to this area. The obstruction impedes the flow of urine down to the bladder, causing the urine to back up in the kidney and dilate it (hydronephrosis).
Older children may have back or flank pain. The pain may be associated with nausea and vomiting. Other symptoms might include bloody urine, a urinary tract infection (often with a fever), or might even be a vague abdominal pain.
Ante-natal Hydronephrosis-UPJ obstruction usually occurs during fetal development.
Intrinsic narrowing or stricture at junction of the ureter and the renal pelvis.
Malrotation of kidney or Horse-shoe kidney may cause UPJ obstruction.
Extrinsic – UPJ obstruction can also be caused by a crossing blood vessel over the ureter and causing constriction.
UPJ obstruction may be associated with scar tissue, infection, a benign polyp, or kidney stones or external compression like tumour.
The goal of treating a UPJ obstruction is to preserve renal function.
In some children, an ultrasound may show a significant amount of dilation (hydronephrosis) but the kidney functions and drains well. In this situation, we will closely follow your child with repeated imaging studies.
In situations where the kidney function is compromised, surgical intervention is needed. The surgical procedure to correct the obstruction is called a pyeloplasty.
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