Drogosis Achillefs Urological Surgeon Athens Greece

URETEROPELVIC JUNCTION OBSTRUCTION

Ureteropelvic Junction Obstruction

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The ureteropelvic junction obstruction is a congenital anomaly commonly developing in children.

The ureteropelvic junction connects the ureter to the renal pelvis.

In appearance it resembles a sink trap.

In this condition, a congenital stenosis blocks normal urine flow, increases pressure in the renal pelvis and causes it to dilate.

Diagnosis

Ultrasonography

Given the wide application of ultrasonography during pregnancy, most of the cases are diagnosed in the fetus.

If the prenatal ultrasound provides data indicating the presence of ureteropelvic obstruction, the ultrasound is repeated two days after childbirth to confirm the results.

Voiding cystourethrography

This is an imaging study performed to rule out other congenital conditions that may be responsible for renal pelvis dilation (vesicoureteral reflux, posterior urethral valves, ureterocele).

Dynamic renal scintigraphy

The scan is performed between the 4th and the 6th week after childbirth.

It provides information on the renal function and type of obstruction.

Treatment

If the kidney dilation is small, it causes no symptoms (pain, urinary tract infections) nor does it affect renal function; it simply needs to be monitored.

In cases when the kidney dilation is large, and may affect renal function in the future, the treatment of the stenosis is recommended.

The treatment is surgical and restores the affected part of the ureter, either with open surgery, laparoscopically or robotically-assisted.

The ureteropelvic junction obstruction is a congenital anomaly commonly developing in children.

The ureteropelvic junction connects the ureter to the renal pelvis.

In appearance it resembles a sink trap.

In this condition, a congenital stenosis blocks normal urine flow, increases pressure in the renal pelvis and causes it to dilate.

Diagnosis

Ultrasonography

Given the wide application of ultrasonography during pregnancy, most of the cases are diagnosed in the fetus.

If the prenatal ultrasound provides data indicating the presence of ureteropelvic obstruction, the ultrasound is repeated two days after childbirth to confirm the results.

Voiding cystourethrography

This is an imaging study performed to rule out other congenital conditions that may be responsible for renal pelvis dilation (vesicoureteral reflux, posterior urethral valves, ureterocele).

Dynamic renal scintigraphy

The scan is performed between the 4th and the 6th week after childbirth.

It provides information on the renal function and type of obstruction.

Treatment

If the kidney dilation is small, it causes no symptoms (pain, urinary tract infections) nor does it affect renal function; it simply needs to be monitored. 

In cases when the kidney dilation is large, and may affect renal function in the future, the treatment of the stenosis is recommended.

The treatment is surgical and restores the affected part of the ureter, either with open surgery, laparoscopically or robotically-assisted.