Ureteropelvic Junction Obstruction 

The urinary system includes the kidneys, ureters, bladder, and urethra. The kidneys produce urine, which is drained into the bladder by small tubes called ureters. Ureteropelvic Junction (UPJ) Obstruction is a condition in which an abnormality in the ureter obstructs the normal flow of urine. When urine cannot properly drain into the bladder, it will pool in the kidney, causing the kidney to swell. This condition is referred to as hydronephrosis. A UPJ obstruction can occur in one, or both, ureters.

Urine that is unable to drain adequately can make a child quite ill. Typically, a kidney infection will occur, secondary to the urine's inability to drain correctly. Once an infection of the kidneys is diagnosed, x-rays will be needed to determine whether there are structural abnormalities. A kidney/bladder ultrasound (RUS) will be obtained to evaluate for the presence of hydronephrosis. Your child will also have a renal lasix scan (MAG III with lasix) to evaluate the kidneys' ability to drain and to evaluate whether there is an obstruction in the tubes.

Surgical Treatment

The surgical procedure used to correct this problem is called a pyeloplasty. This involves a small incision being made on the side that has the obstruction. The abnormal part of the ureter is removed, and the remaining part of the ureter is reconnected to the kidney. After surgery, your child will have a small tube (penrose drain) coming from the incision. This tube is to keep drainage away from the incision as it heals. It will be left in for 7–10 days, at which time you will return to the Urology Clinic to have it removed. In addition, your child may have a tube (stent) left in the ureter, which will allow the kidney to drain and give the ureter time to heal. This will be removed 6–8 weeks after surgery. Stent removal is a very simple procedure requiring approximately 30 minutes and will be performed in Day Surgery. Follow-up is a clinic appointment with a renal ultrsound and a MAG III with lasix scan several months after surgery.