Obstructive defects of renal pelvis and ureter
What is it?
Obstructive genitourinary defects are congenital narrowing or absence of urinary tract structures. Symptoms of these defects depend on the severity and the degree and leves of the obstruction. Ureteropelvic junction (UPJ) obstruction is the most common obstructive defect. In this defect, the place where the ureter and the kidney join is obstructed, therefore urine cannot pass easily. The ureterovesical junction (UVJ) is where the ureter enters the back wall of the bladder. If the UVJ is obstructed, urine backflow and enlargement of the ureter can be caused. These and other defects may interfere with the normal fetal development, there could be lack of amniotic fluid, fetal lung developmental problems, and kidney damage.
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Obstructive defects of renal pelvis and ureter.
Additional names
This group contains additional names:
- Ureteropelvic junction (UPJ) obstruction
- Ureterovesical junction (UVJ) obstruction
- Occlusion of ureter
Signs & symptoms
Signs and symptoms may include ureter dilation, back pain, flank pain, vomiting, nausea, blood in the urine, urinary tract infection and kidney stones, abdominal mass, and poor growth in infants. Sometimes, symptoms may not be noted until ureters dilatation will be seen on imaging.
Diagnosis
Diagnosis of urinary defects such as UPJ and UVJ may be seen in prenatal US. After birth, renal bladder US, renal scans, MRI and CT may help diagnose the defects. Blood samples may be taken to test blood urea nitrogen and creatinine test the kidney function.
Treatment
Urinary tract defects have to be treated if renal function is impaired. For newborns, treatment may include cutaneous distal ureterostomy which allows the affected ureter and kidney to decompress. The obstruction may be managed endoscopically with a laser to open up the obstruction. A balloon may be inserted to expand the narrowed area and then a stent may be placed. Ureteral reimplantation may be done to remove the part of the abnormal ureter. It may be done laparoscopically. Pyeloplasty in the classic treatment for infants with UPJ, where the ureter is reattached to the renal pelvis to create a wide opening.
☝️ This is not a substitute for professional medical advice. Please consult with your physician before making any medical decision.
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