Ureteropelvic Junction Obstruction Treatment in Gilbert, AZ

What is Ureteropelvic Junction (UPJ) Obstruction?

The ureter actively propels urine from the kidney down into the bladder. A Ureteropelvic Junction obstruction describes a blockage in this area. More specifically, the blockage is where the ureter connects to the renal pelvis in the kidney. Utero refers to the uterus. Pelvic is about the renal pelvis in the kidney, not your pelvic bone. A UPJ obstruction can impede the flow of urine from the kidney to the bladder.

At Southeast Valley Urology, our board-certified urologists are highly trained in treating a ureteropelvic junction obstruction. Contact our urology clinic in Gilbert, AZ to schedule an appointment at (480) 924-7333.
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Symptoms of a Ureteropelvic Junction Obstruction

Increased pressure inside the kidney can over time cause deterioration of kidney function.

A UPJ may lead to a range of symptoms and potential complications including:

• Pain on the sides and back of your abdomen
• Discomfort between your lower ribs and hips
• Abdominal pain
• Blood in the urine (hematuria)
• Frequent urinary tract infections (UTIs)
• Nausea and vomiting (in severe cases)
• Hydronephrosis is the dilation of the kidney due to retained urine

If you suspect you have any of these symptoms, talk to Dr. Simoncini right away. You can get help to test and diagnose a UPJ obstruction.

What Causes a Ureteropelvic Junction Obstruction?

The obstruction can be due to the following causes:

• Congenital, the patient is born with it
• Structural abnormalities in the urinary tract
• May develop over time
• Can occur after trauma
• Appears after a change in body shape with age
• Scar tissue
• Fibrous tissue
• Kinking
• A blood vessel
• Kidney stones can migrate to the UPJ and cause blockages
• Tumor

Testing to Determine Ureteropelvic Junction Obstruction

To diagnose UPJ obstruction, Dr. Simoncini may use various methods, including:

• Imaging Studies: Ultrasound, CT scans, or MRIs can provide detailed images of the urinary tract and reveal any blockages or abnormalities
• Renal bladder ultrasound (RBUS): This procedure uses sound waves to outline the kidneys and bladder. It will enable us to see the degree of hydronephrosis (dilation of the kidney)
• Intravenous Pyelogram (IVP): A contrast dye is injected into the bloodstream, allowing for X-ray visualization of the urinary system
• Nuclear Renal Scan: This test assesses kidney function and can reveal whether the obstruction is affecting kidney health
• MAG III renal scan: This helps see the degree of blockage through an IV line with a special solution injected into the veins to see the kidneys clearly for images
• MRI/MRU: MRI is a radiation-free diagnostic procedure that uses a combination of a large magnet, radio frequencies, and a computer to produce detailed images of the kidneys, ureters, and bladder for about 40 minutes

Treatment Options

If the kidney function is compromised, surgical intervention may be needed. In young children, symptoms can sometimes resolve on their own. Dr. Simoncini will closely monitor your situation with ongoing imaging studies to see what is best for your kidney function.

Some options for treatment include:

• Pyeloplasty – Surgery to cut out the area and reconnect the ureter to the kidney
• Endopyelotomy – A telescope with a wire is passed to the kidney and the scar tissue is cut open from the inside, using much less invasive means, with the temporary internal tube removed after four to six weeks
• Laparoscopic Pyeloplasty- Robotic surgery without a large incision, can be performed through three small keyhole incisions in the abdomen and is associated with shorter hospitalization, decreased pain following surgery, quicker recovery and return to normal activities

The choice of treatment for UPJ obstruction depends on the severity of symptoms and the degree of obstruction.