How is a UPJ obstruction diagnosed?
- A UPJ obstruction can often be diagnosed before birth as a condition called hydronephrosis — during a prenatal ultrasound study.
- serial ultrasound in antenatally diagnosed hydronephrosis,to check for any changes over time.
- The good news is that often these blockages don’t cause any problems.
- Renal ultrasound: New born baby will have ultrasound test to look at the kidneys. This study tells how serious the hydronephrosis is.
- Voiding cystourethrogram: This special x-ray is used to show the anatomy of your child’s bladder and urethra.
- Renal scan: it helps to measure the functional status of the two kidneys and estimate the degree of blockage in the urinary system.
- Blood tests.
- Urinalysis and urine culture
In general, your child's treatment depends on the severity of the blockage. In mild cases, the flow of urine is affected only minimally and your child will likely not experience any symptoms at all. If the obstruction is larger, your doctor may choose to closely monitor your child with repeated ultrasound tests. In the most severe cases, where your child's kidney is at risk of damage from chronic backup of urine, surgery may be necessary.
Mild to moderate cases
- Doctor may recommend a series of follow-up imaging studies to detect worsening or causing any kidney problems.
Child need to be seen monthly in first 3 to 4 months of life to figure out the severity of the obstruction.
Severe cases
- Children with more severe cases of UPJ obstruction may require surgery. The most common reasons are recurrent kidney infections, worsening of hydronephrosis, or deteriorating kidney function.
The aim of the surgery is to correct the blockage in the ureter and allow urine to flow properly. Remove the blocked segment, and reconnect the drainage system.
There are two methods of surgeries in UPJ obstruction.
Open surgery:
The surgical procedure done in UPJ obstruction is called dismembered pyeloplasty. and the procedure has proven very effective over the years.
Laparoscopic surgery;
Evolving modality of pyeloplasty,equally effective in the expert hands.There are advantages of smaller incision,less trauma and pain, lesser hospital stay.
If detected early, most UPJ obstructions don't cause problems. Even larger obstructions can be managed and have good urinary function. If left untreated, however, the chronic obstruction can damage your child's kidneys.
