Ureteropelvic junction (UPJ) obstruction was defined as an blockage of the urine flow which is from the renal pelvis to the proximal ureter. Congenital abnormalities are observed in both children and adults, but adults may also suffered with UPJ obstruction followed by previous surgery or other disorders that may cause inflammation to the upper urinary tract. If it was left untreated, it can cause progressive deterioration in normal functioning kidney. Recently, Pelvi-Ureteric Junction Obstruction (PUJO) is most common suspected even before birth on a routine pregnancy ultrasound scans. In the past, infants with PUJO mostly suffered with urinary infection.
The common symptoms of a PUJ obstruction are: Flank pain usually worsened after consuming more volumes of fluids, particularly alcohol, repeated urinary tract infections, blood in urine (haematuria). Rare symptoms includes, the swollen or obstructed kidney can be felt in the flank region
UPJ obstruction is the most general cause of hydronephrosis which can be detected on prenatal ultrasound in newborns. The blockage may range from minimal to severe. Mild cases generally won’t damage the kidney or harm its function, but they can influence the child to urinary tract infections. Severe cases may effects significant harm to the kidney.
In some cases, a PUJ obstruction is detected by the presence of the above symptoms, follow-on in further investigations can reveal the PUJ obstruction
Usually, a PUJ obstruction can be detected incidentally by ultrasound or CT scans. A PUJ obstruction has a typical visualization on CT scan, even though not all patients with this appearance may have obstruction to the urine flow. It is only for the patients who are having a physical obstruction they may require treatment.
Basic tests includes: Urine culture to eliminate a urine tract infection. Blood tests to check baseline kidney function.