PUJ obstruction

What Is It ?

The renal pelvis is the structure that drains urine from the kidneys. The structure that carries the urine from the renal pelvis into the bladder is called the ureter. The narrow area where these two structures meet is called the ureteropelvic junction (PUJ). A blockage in the UPJ can inhibit the flow of urine.

Symptoms

Symptoms of UPJ in children include: fever, nausea and vomiting, failure to thrive. most cases of UPJ obstruction are detected by antenatal ultrasound Blockage of the UPJ can be present from birth. It is a common urinary tract abnormality. Most of the time the problem appears in childhood. In some people, however, symptoms may not show up until after puberty. A doctor will suspect a UPJ obstruction if the renal pelvis and kidneys are dilated. This dilation is known as hydronephrosis.

Other diagnostic investigations include:

  • Doppler ultrasound.
  • Intravenous Urography
  • Renal scintigraphy to assess the differential renal function.
How It's Done

If a UPJ obstruction is clearly present and is affecting kidney function, surgery is needed to repair it. The surgery can be done Endourological (Endopyeloplasty, endopyeloptomy), laparoscopic or open. This operation involves cutting the ureters to remove the blockage, then reattaching it to the renal pelvis. This procedure can be done through an endoscope or with open surgery.

Risks

Endoscopic techniques are frequently performed with adults. They are less commonly used with children. They carry a slightly lower success rate than open surgery. However, there are few complications and the person is able to recover more quickly.