PUJ Obstruction / UPJ Obstruction
Kidneys filter the blood to remove waste, excess fluid, and maintain electrolyte levels. Renal pelvis connects the kidneys to the ureters, and any obstruction in the renal pelvis is called UPJ obstruction (ureteropelvic junction obstruction). The obstruction can be total or partial that prevents urine to pass through from the kidneys to the ureters, and this can lead to hydronephrosis- the swelling of the kidneys because of urine accumulation.
Here are some causes of obstruction of ureteral junction:
- Congenital: Congenital ureteropelvic junction obstruction is the most common case, hydronephrosis (enlarged kidney) is detected during ultrasound of pregnant women
- Kidney stones
- Previous surgery
- Abnormal blood vessels
- Upper urinary tract swelling
Sign and Symptoms
Here are some ureteropelvic junction obstruction symptoms that a person may experience:
- Abdominal or flank pain
- Presence of blood in the urine (hematuria)
- Kidney stones
- Urinary tract infection
- Kidney infection
- High blood pressure
- Deterioration of kidney functioning
Urologists will order some tests to help them diagnose obstruction of the ureteropelvic junction. These are tests or diagnostic procedures that your doctor will order:
- Blood urea nitrogen (BUN) and Creatinine tests: These tests will check the functioning of the kidneys; high levels of urea nitrogen and creatinine indicates that there is a problem of the kidney’s blood filtration or a presence of pelvic ureteric junction obstruction.
- Intravenous pyelogram (IVP): A contrast material is injected into the bloodstream and x-ray is taken, the doctor can check the patency of the kidneys, renal pelvis, and ureters.
- Nuclear Renal Scan: A radioisotope, which releases gamma rays, will be injected into the bloodstream. A gamma camera is used to detect the rays and images are taken and stored on the computer. This scan will help assess, check the functioning of the kidneys, and look for any obstruction of the ureteropelvic junction.
- CT Scan or MRI: Imaging to check for any obstruction of ureteropelvic junction and condition of the kidneys, renal pelvis, ureters.
Usually, for children 18 months and below, poor renal functioning can be noted but most of the time it will improve after a few months as they grow. Antibiotics will be given for prophylaxis purposes and children will be monitored every 3 to 6 months. Ultrasound will be done to check the presence of pelvic ureteric junction obstruction and to check the condition of the kidneys, renal pelvis, and ureters. While some of the children with congenital ureteropelvic junction obstruction worsen.
Surgery will be done to severe pelvic ureteric junction obstruction to prevent damage to the kidneys. Pyeloplasty is a ureteropelvic junction obstruction treatment that can be done through open surgery or laparoscopic method.
- Open pyeloplasty: It is an effective ureteropelvic junction obstruction treatment. A 2-3 inch incision is made below the ribs to access the ureteropelvic junction obstruction. Then, the parts that cause blockage will be removed and healthy parts of the renal pelvis and ureters will be reconnected to create a wide passageway for urine. A stent will be inserted to the ureter to facilitate healing and allowing urine to drain through it. When healed, the ureteral stent will be removed.
- Laparoscopic pyeloplasty: It is a ureteropelvic junction obstruction treatment that is performed with 3 incisions with 1-1.5 cm in length on the abdomen. A long, thin, lighted scope and small instruments will be used to repair the ureteropelvic junction obstruction. A ureteral stent is placed to the repaired ureter to allow healing and facilitate urine drainage. The stent will be removed after healing (at least 4 weeks) in the urologist’s clinic.
Pyeloplasty is a safe and effective ureteropelvic junction obstruction treatment, and the success rate of this surgical procedure is more than 95 percent. Here are some things you can expect after the surgery:
- Pain medications are given to alleviate pain and discomfort because it is expected that the ureter is swollen for a few days.
- Scheduled clinic visits to check the status of the patient and the post-operative site.
- The ureteral stent will be removed after more or less 4 weeks.
- The urologist may order an ultrasound a few weeks after the surgery to check for hydronephrosis.
What Is The full form of PUJ Obstruction or UPJ Obstruction?urofertility2020-08-27T06:33:47+00:00
PUJ obstruction means Pelvic Ureteric Junction obstruction and UPJ obstruction means Ureteropelvic Junction obstruction.
What Is PUJ Obstruction or UPJ Obstruction?urofertility2020-08-27T06:34:20+00:00
Ureteropelvic junction obstruction happens when there is a total or partial obstruction in the renal pelvis, the part where kidneys and ureters meet. Most cases are congenital ureteropelvic junction obstruction, while other cases that occur in adults are caused by kidney stones, previous surgery, abnormal blood vessels, tumor, and upper urinary tract swelling.
What are the treatment options available for PUJ Obstruction or UPJ Obstruction?urofertility2020-08-27T06:34:40+00:00
Ureteropelvic junction obstruction treatment is pyeloplasty, which can be done through open surgery or laparoscopic method. Both have same length of hospital stay but laparoscopic method is more costly. Both have the same high success rate of surgeries.
Is PUJ Obstruction or UPJ Obstruction treatment successful?urofertility2020-08-27T06:35:10+00:00
Ureteropelvic junction obstruction treatment is successful because it has a success rate of more than 95 percent.