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This refers to a partial blockage of the ureter where it enters the kidney
(renal pelvis). This results in dilation of the collecting system within the
kidney, called hydronephrosis. A severe degree of hydronephrosis may result
in diminished renal function; and in its most extreme form, virtual complete
loss of renal cortex. Ureteropelvic junction obstruction (UPJ obstruction)
is commonly diagnosed in the newborn infant by maternal prenatal ultrasound
study. In older children/adolescents it may present with abdominal/flank pain,
hematuria (blood in the urine), or urinary tract infection.
This condition is diagnosed with various imaging modalities (most commonly
renal ultrasound) and may be followed conservatively or managed surgically. If
a surgical obstruction does exist, the condition is amenable to correction
with an operation called pyeloureteroplasty (UPJ repair). This is attendant
with gratifying results and resolution in the vast majority of cases. Selected
patients may be candidates for laparoscopic intervention or a minimally invasive
technique called endopyelotomy. Again, intervention is expected to attain and
preserve optimal renal function.
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