Ureteropelvic Junction Stenosis

Ureteropelvic junction stenosis is a health problem known as UPJ stenosis and is frequently observed in children in the womb. It causes obstruction or stenosis between kidney and ureter due to developmental disorders.

If this disease, which is also observed in adults, is not treated, it can cause disruption in kidney functions and much more serious health problems. Therefore, if there is serious obstruction, it requires treatment as soon as it is detected. In this article, we examined what is UP stenosis and how it is treated.

is a health problem known as UPJ stenosis and is frequently observed in children in the womb. It causes obstruction or stenosis between kidney and ureter due to developmental disorders. If this disease, which is also observed in adults, is not treated, it can cause disruption in kidney functions and much more serious health problems. Therefore, if there is serious obstruction, it requires treatment as soon as it is detected. In this article, we examined what is UP stenosis and how it is treated.

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Urine produced by the kidneys is first collected in a pool called the renal pelvis and then transported to the bladder (urinary bladder) by tube-like structures called ureters (ureter). The stenosis that develops at the junction of the renal pelvis and the ureters is defined as ureteropelvic junction stenosis. With the disruption of the flow of urine from the kidneys to the ureter, urine accumulates in the renal pelvis and causes enlargement called hydronephrosis.

What is Ureteropelvic Junction Stenosis?

The ureteropelvic junction is the name given to the point where the ureter meets the kidney pool (renal pelvis) where urine is collected. The urine produced by the kidney first goes to the kidney pool through small channels and is passed from the body through the ureter (urinary canal) to the bladder. Stenosis or obstruction in the ureteropelvic junction causes difficulties in the urinary excretion process.

UPJ stenosis is usually a congenital disorder and is observed in children. The disease is also called renal outflow stenosis. In patients with stenosis, disturbances in urine conduction occur and excessive urine accumulation occurs in the kidney.

For this reason, enlargement occurs in the kidney pool and channels, and a decrease in kidney functions is observed. When left untreated or delayed, it can cause consequences up to complete loss of kidney function.

What are the Symptoms of Ureteropelvic Junction Stenosis?

UPJ stenosis is detected by routine tests - ultrasound during pregnancy and the following symptoms can be mentioned in its formation:

pain in flank
hematuria (bloody urine)
Developmental problems in the baby
swelling in the abdomen
urinary tract infections
kidney infection
Vomiting
developmental delay

What Causes Ureteropelvic Junction Stenosis?

Ureteropelvic junction stenosis is usually congenital. If UP stenosis develops while the baby is in the womb, enlargement of the kidney, or hydronephrosis, may occur. If disorders occur in the development process of the kidneys and urinary canals, stenosis can be observed in the urinary canal.

Other causes include overdeveloped renal vessels and conditions such as renal vessels passing over the junction. This disease, whose exact cause is unknown, usually occurs in children.

UPJ stenosis, which is observed in 1 in every 1500 births, commonly occurs on the left side and is more common in males.

However, in some cases, it can also be seen in adults. In this case, previous infections such as tuberculosis, surgeries for stone treatment, various traumas and accidents, and masses that press from the outside can also be considered as causes of stenosis.

How is Ureteropelvic Junction Stenosis Diagnosed?

The diagnosis of ureteropelvic junction stenosis is often made during routine check-ups in pregnant mothers. It can be detected when checking with ultrasound, although in rare cases, it occurs years after birth. In this case, it is detected in radiological examinations for pain and urinary infections.

It is usually diagnosed during the detection of other diseases or during routine controls. In some patients, the diagnosis of UPJ stenosis can also be made by kidney scintigraphy. Possible treatment methods are evaluated in diagnosed patients.

Patients with impaired kidney function, who are getting worse despite the drugs used, and who are exposed to severe pain and infections, should be treated urgently. Early diagnosis is extremely important so that the disease does not progress and affect the kidneys. Therefore, early treatment methods should be initiated in diagnosed patients.

Ureteropelvic Junction Stenosis Treatment Methods

The treatment in UPJ stenosis is surgical operation and this operation is called “Pyeloplasty”. During the operation, the UP junction structure is performed by removing the stenosis area and re-suturing the pelvis to the ureter (uretero-pelvic anatomosis-pyeloplasty).

UP stenosis surgery can be performed open or closed (laparoscopically). The application of robotic surgical methods and minimal incisions in the body in laparoscopic surgery help the patient to recover in a short time. These patients are usually discharged a few days after surgery. In addition, the scar left on the body after recovery in patients is almost invisible.

However, endoscopically performed "Endopyelotomy" surgery is evaluated in patients who have had the same operation before and the disease has recurred.

The surgery to be performed should be decided together with the specialist physician. For this reason, it is recommended that patients who show the symptoms listed and who have been diagnosed should consult a physician without delay. Timely initiated treatment methods are known to be more effective.

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