Ureteropelvic Junction Obstruction - How It Can Be Treated?

The urinary system is the second most disease prone area in the human anatomy, after the cardiovascular system of our body. Gallbladder stones, urination problems, kidney failure and many more add to the list of such diseases. The Ureteropelvic Junction Obstruction (UPJO) is another addition to the list of troubles people might face concerning their urinary tract. According to two research papers posted in the Central European Journal of Urology, UPJO and its remedies have been of common interest to medical researchers, recently. Let’s delve into further details of this disease.

The urinary system
The kidney extracts the fluid from the blood, which is then converted into urine with the help of renal parenchyma. It is a compound found in the kidney itself. Once the urine is produced by the kidney, it is transported to renal pelvis, which is the first part of the urine collection system. The renal pelvis is attached to the kidney itself. The urine finally passes through the ureter to the bladder, which excretes the urine, once it is full, through the urethra.

Ureteropelvic Junction Obstruction  UPJO
It is in the renal pelvis where the UPJO occurs. UPJO is the term commonly used to denote any blockage arising in the path of the urine from the renal pelvis to the ureter. The reason behind this blockage could be undetermined but in most of the cases one of the two happens:

• A blood vessel might pressure a blockage, going above the ureter
• There might be a non-functioning segment in the ureter, which is also termed as ‘congenital narrowing of the ureter’.

Symptoms of UPJO
UPJO can be very difficult to identify before any test because its symptoms are very similar to symptoms of gallbladder stone, urination difficulties, etc. Few of the symptoms, according to the patients undergoing treatment for UPJO, are as follows:
• Sudden pain in the upper abdomen portion of the body

• Infection in the renal pelvis (which can only be identified after tests)
• Crystalline formations near the ureter (stones),
• Haematuria (blood mixed with the urine)

Recommended tests
It is quite astonishing how, in a few cases, UPJO may not cause any symptoms and hence pass undetected. But the commonly recommended tests for those undergoing such pain are:
• CT scan
• Ultrasound
• MRI

In the imaging output from these scans, the dilation in the renal pelvis can be caught. Other than these tests, several other tests are recommended to evaluate UPJO. For example, a renal sonogram may show a dilated renal pelvis, commonly known as hydronephrosis or pelvicaliectasis.

Treatment of UPJO
Transperitoneal laparoscopic pyeloplasty is currently the most popular treatment for UPJO. According to a research, 62 laparoscopic pyeloplasties were carried out. The average age of the patients consulting a specialist was 40 years, out of which 52% were female. The most common reason for consultation was urethral pain with or without infections, and 94% of patients had a total or partial obstructive pattern. The main reason behind the patients’ urge to treat UPJO with pyeloplasty was that it has the advantages of a minimally invasive surgery.

Conclusion
Even a minute pain in the abdomen can be infectious.Hence, it is recommended to undergo the medical tests that have been mentioned and treat UPJO with pyeloplasty before perilous complications arise.

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