Ureteropelvic junction (UPJ) obstruction is any abnormality that slows or blocks the flow of urine through the kidney pelvis, the funnel-shaped area between the hollow, middle part of the kidney and the urine-draining tube known as the ureter.
WHAT ARE THE SYMPTOMS?
Symptoms of UPJ include:
CAUSES AND RISK FACTORS
- Intermittent flank pain (pain in the back between the ribs and hips);
- Recurrent urinary tract infections;
- Blood in urine (hematuria);
- Bulging or swelling in the abdomen; and
- Kidney stones.
The congenital cause of UPJ obstruction appears to be an abnormality in the muscle fibers at the point where the ureter connects to the central part of the kidney pelvis. UPJ obstruction may also be caused by the growth of scar tissue at the top of the ureter, which narrows the passage.
One or more of the following tests may be used to help diagnose UPJ:
- Neo-natal ultrasound;
- X ray;
- Computed Tomography (CT) scan;
- Intravenous urography (also called intravenous pyelogram, or IVP);
- Diuretic renal scan;
- Helical CT scan; or
- Retrograde pyelography.
Treatment for UPJ obstruction is only necessary if a blockage significantly restricts urine flow or if a patient experiences persistent pain. Treatment options include:
- Retrograde balloon dilation;
- Retrograde fluoroscopic endopyelotomy;
- Retrograde ureteroscopic endopyelotomy;
- Antegrade endopyelotomy;
- Open pyeloplasty; and
- Laparoscopic pyeloplasty.