Is it a blockage in the passageway of urine from the kidney? Let's talk about it simply.

Did the doctor say during your prenatal scan that one of your baby's kidneys looked a little swollen? Or does your little one often get urinary tract infections? Maybe you're talking about a little pain in the side of your stomach? Today, we're going to talk about a condition that can cause this, but isn't talked about much. This is called Ureteropelvic Junction Obstruction, or UPJ Obstruction for short.

Simply put, what is UPJ Obstruction?

To understand this, let's first look at how our kidneys work. Think of our kidneys as two water filters. The blood in our body is filtered, and the waste and unnecessary water in it are collected and formed into urine.

The urine that forms in this way collects in a funnel-like part inside the kidney (the renal pelvis) . Then, the urine travels down a thin tube (the ureter) that starts from this funnel and collects in the bladder.

The point where the kidney funnel and the ureter that begins there connect is what we call the Ureteropelvic Junction (UPJ).

Now you understand, right? UPJ Obstruction is when there is a blockage or obstruction at that junction, that is, where the funnel and the tube meet. Just like when a pipe in a sink gets blocked, the urine can't go down and starts to fill up inside the kidney. In medical terms, this is called (Hydronephrosis) when the kidney fills up with urine.

Is this situation serious?

Yes, UPJ Obstruction is a condition that needs to be taken care of. Because, if not treated properly, the kidney can be damaged and its function can be reduced due to the urine filling up inside the kidney for a long time. In the worst cases, the kidney can even become completely dysfunctional (kidney failure).

But don't worry. If it's caught early and treated properly, it can be completely cured. Most children can live healthy lives without any long-term effects.

What are the symptoms of this condition?

The symptoms of UPJ Obstruction can vary with age. Sometimes a young child may not show any symptoms. However, there are some common symptoms that can be seen.

What is the reason for this? Why is this happening?

Congenital causes

Most of the time, more than 95% of cases, UPJ Obstruction is a congenital condition . This means that the blockage occurs because the kidneys and ureters do not form properly while the baby is growing in the womb. The exact cause of this is not yet known. It just happens.

Sometimes, this blockage can also be caused by a blood vessel that supplies blood to the kidney passing in the wrong place, namely right over the UPJ joint.

Causes that occur in adulthood

This condition is very rare in adults. If it does occur, it may be caused by:

• Kidney stone blockage
• Upper urinary tract infections
• Scars after surgery in that area
• Swelling in the upper part of the urinary system

How do you find this, Doctor?

This condition is often diagnosed during pregnancy, before the baby is born, during an ultrasound scan . If the scan shows that one of the baby's kidneys is swollen beyond normal size (hydronephrosis), doctors will suspect this.

After the baby is born, several more tests may be done to confirm this condition and see how much damage has been done to the kidney.

What are the treatments for this?

The treatment method is determined by many factors, such as the severity of the blockage, kidney function, and the child's age.

1. Watchful Waiting

Don't be surprised, most babies born with this condition are initially treated with observation without any surgery. This is because there is a good chance that the obstruction will resolve on its own as the child grows. This can happen within the first 18 months of the child's life.

During this time, the doctor will perform ultrasound scans at regular intervals to check for any swelling in the kidney. He may also continue to give low-dose antibiotics to prevent urinary tract infections.

2. Surgery

If the swelling of the kidney increases during the observation period, if the kidney function decreases, if the child has frequent cramps, or if the congestion does not improve after 18 months, the doctor will recommend surgery.

The main surgery performed for this is called Pyeloplasty .

• Pyeloplasty: This involves cutting out the blocked, narrowed part of the ureter and reconnecting the healthy ureter to the kidney. This creates a wider path for urine to flow through. This surgery is very successful (more than 95% successful).
• This surgery can be performed as a normal open surgery or through small incisions, such as laparoscopic surgery.

Another treatment method is Endopyelotomy . In this, without any incisions, a small camera (endoscope) is passed along the urethra, and the blockage is cut from the inside and widened. However, this is less successful than Pyeloplasty.

What happens after treatment?

It usually takes about two to four weeks to fully recover from surgery. But it varies from person to person. Your doctor will explain this to you in detail.

If diagnosed early and treated properly, the outlook for this condition is very good . Most children can live a normal life without any long-term complications.

When do you need to see a doctor?

If you or your child has the following symptoms, see a doctor immediately.

• If there is blood in the urine
• If there is a knot in your stomach that you can't get your hands on
• If you have pain in the upper abdomen or back
• If you have a fever (especially with a urinary tract infection)
• If a young child is not gaining weight and seems to be failing to thrive

It's normal to feel a lot of fear and anxiety when you hear about this condition, especially for an expectant mother. You may wonder, "Did I do something wrong?" But remember, this is no one's fault. It just happens. The important thing is, there are very effective treatments for this. Talk to your doctor about this openly. Ask him or her any questions you may have.