Ureteropelvic junction or UPJ obstruction refers to blockage inside the kidneys. Blockage occurs specifically at the upper end of the ureters, where the renal pelvis is located. It’s the tube that drains urine out of the kidney and moves it towards the bladder. The renal pelvis looks like a funnel. However, its main function is to collect urine out of the kidney. In a healthy individual, each kidney has a ureter that contains a renal pelvis.
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The main function of kidneys is to remove waste matter out of the blood along with excess water that’s no use to the body. Hence, it creates urine that collects at the UPJ. From there, the blood flows towards the ureters in both kidneys and then the bladder.
However, when UPJ obstruction occurs, the flow of urine from the ureters to the bladder is interrupted. In turn, this creates a pool of urine that damages the kidneys.
Common Symptoms of UPJ Obstruction
As per scientific studies, the occurrence of UPJ obstruction is 1 in 1000-1,500 people in the US. Although the ratio appears relatively lower in comparison to other medical health conditions, it doesn’t make it any less important. Nearly all people find it painful and extremely intense to endure during regular activities.
Whether male or female, the kidneys are affected heavily in both once UPJ obstruction manifests symptoms. Speaking of symptoms, let’s take a look at some of the most common ones to help in early detection:
- Urinary tract infection (with high fever)
- Abdominal lump
- Kidney stones
- Vomiting
- Upper abdomen and back pain
- Blood in the urine
- Poor body growth in infants
Typical Diagnosis Methods of UPJ Obstruction
UPJ obstruction is usually more prevalent in women than men because females tend to experience more hormonal changes. Normally, during childbirth, regular ultrasounds are effective in detecting any damages to the kidney that may also affect the embryo/infant. Here are the several diagnosis methods that expert urologists opt for:
- Creatinine clearance
- Kidney nuclear scans
- Electrolytes
- CT scan
- IVP
- BUN
- Voiding cystourethrogram
Main Causes of Adult Ureteropelvic Junction in Adults
As experts believe, the majority of the UPJ Obstructions are prevalent since birth in affected patients, but it’s not until they’re an adult that the symptoms start manifesting. As a fetus, an individual might not develop the kidney and its internal structure fully. As a result, UPJ obstruction can be a big issue as the individual grows.
Since a fetus can have UPJ obstruction before birth, it’s clearly indicated the health condition is genetically transferred from parents to their children. The inherited tendency runs through generations, causing UPJ obstruction in several members of the same family.
Several common causes and risk factors that lead to UPJ obstructions in adults include:
- Smoking
- Complicated renal surgeries
- Kidney infections
- Genetic /hereditary health conditions
Possible Treatment Methods for Adult Ureteropelvic Junction
Many doctors believe that if an infant has developed UPJ obstruction as a fetus, the condition may potentially improve over the course of 18 months or so. However, in that time period, a professional urologist will recommend taking regular ultrasounds to monitor the condition. Regular ultrasounds help urologists determine whether the condition will cause lasting harm to the physical health of the infant or not.
In case the urine flow doesn’t improve, and the obstruction remains even after 18 months have passed since early diagnosis, a professional urologist might recommend surgical treatment. Doctors have found surgeries to be extremely effective at solving UPJ obstruction problems. The most common type of surgery is open pyeloplasty.
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Open Pyeloplasty
In this procedure, the surgeon will remove the UPJ and widen the opening that leads to the renal pelvis inside the ureters above the affected kidney. The main objective is to remove the obstruction so that urine can flow freely and eliminate chances of infection. Through surgery, the removal of UPJ obstruction in the renal pelvis can significantly reduce the symptoms and improve overall physical health condition.
The beginning of the procedure requires a minor incision from where an expert urologist uses surgical tools to remove the UPJ obstruction. An alternative approach involves the use of a fine wire to remove UPJ obstruction by moving closer to the ureters through a minor incision on the body. After the removal of the said obstruction, the professional urologist will install a drain to augment the healing process.
Ureteropelvic Junction or UPJ obstruction: Conclusion
Kidney damage can only worsen in old age, making it difficult to maintain a normal lifestyle. However, at Fifth Avenue Urology, we cater to the need and healthcare requirements of various patients and those with UPJ obstruction as well. You must know that finding the right treatment can prevent the aggressive progression of damage to other parts of the body. Therefore, you must make an appointment with a suitable urologist who has surgical skills like Dr. Yaniv Larish and Dr. Leonard Glickman.
Fifth Avenue Urology is proud of its doctors offering effective treatments and helpful consultations to many patients. Set an appointment with Dr. Yaniv Larish today!
FIFTH AVENUE UROLOGY
Dr. Yaniv Larish
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4 East 76th Street
New York, NY 10021
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212-675-3186