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KEY FACTS
Terminology
Imaging
Pathology
Clinical Issues
TERMINOLOGY
Abbreviations
Ureteropelvic junction (UPJ) obstruction
Synonyms
Pelviureteric obstruction
Definitions
Variable degree of blockage to urine flow at level of UPJ
Most common urinary tract obstruction in pediatrics
May be diagnosed antenatally with sonography or present in infancy or later childhood with UTI, intermittent abdominal pain, vomiting, hematuria
Occasionally found incidentally during trauma work-up
IMAGING
General Features
Radiographic Findings
Ultrasonographic Findings
Fluoroscopic Findings
CT Findings
MR Findings
Nuclear Medicine Findings
Other Modality Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Staging, Grading, & Classification
Gross Pathologic & Surgical Features
Microscopic Features
CLINICAL ISSUES
Presentation
Natural History & Prognosis
Treatment
Selected References
Senol C et al: Changes in Cajal cell density in ureteropelvic junction obstruction in children. J Pediatr Urol. 12(2):89.e1-5, 2016
Brucher N et al: Non-contrast-enhanced MR angiography using time-spin labelling inversion pulse technique for detecting crossing renal vessels in children with symptomatic ureteropelvic junction obstruction: comparison with surgical findings. Eur Radiol. 26(8):2697-704, 2015
Li R et al: Diagnosis and management of ureteral fibroepithelial polyps in children: a new treatment algorithm. J Pediatr Urol. 11(1):22.e1-6, 2015
Parikh KR et al: Pediatric ureteropelvic junction obstruction: can magnetic resonance urography identify crossing vessels? Pediatr Radiol. 45(12):1788-95, 2015
Cutroneo G et al: Altered cytoskeletal structure of smooth muscle cells in ureteropelvic junction obstruction. J Urol. 185(6):2314-9, 2011
Mei H et al: Laparoscopic versus open pyeloplasty for ureteropelvic junction obstruction in children: a systematic review and meta-analysis. J Endourol. 25(5):727-36, 2011
Samarasekera D et al: Endopyelotomy still has an important role in the management of ureteropelvic junction obstruction. Can Urol Assoc J. 5(2):134-6, 2011
Wu Z et al: Novel method for double-J stenting in retroperitoneal laparoscopic dismembered pyeloplasty. Urology. 77(2):354-6, 2011
Baek M et al: Long-term outcomes of dismembered pyeloplasty for midline-crossing giant hydronephrosis caused by ureteropelvic junction obstruction in children. Urology. 76(6):1463-7, 2010
Szavay PO et al: Functional outcome after laparoscopic dismembered pyeloplasty in children. J Pediatr Urol. 6(4):359-63, 2010
Richstone L et al: Pathologic findings in patients with ureteropelvic junction obstruction and crossing vessels. Urology. 73(4):716-9; discussion 719, 2009
VanderBrink BA et al: Reconstructive surgery for lower pole ureteropelvic junction obstruction associated with incomplete ureteral duplication. J Pediatr Urol. 5(5):374-7, 2009
Khaira HS et al: Helical computed tomography for identification of crossing vessels in ureteropelvic junction obstruction-comparison with operative findings. Urology. 62(1):35-9, 2003
Brkljacic B et al: Doppler sonographic renal resistance index and resistance index ratio in children and adolescents with unilateral hydronephrosis. Eur Radiol. 12(11):2747-51, 2002
Rooks VJ et al: Extrinsic ureteropelvic junction obstruction from a crossing renal vessel: demography and imaging. Pediatr Radiol. 31(2):120-4, 2001
Frauscher F et al: Crossing vessels at the ureteropelvic junction: detection with contrast-enhanced color Doppler imaging. Radiology. 210(3):727-31, 1999
Amling CL et al: Renal ultrasound changes after pyeloplasty in children with ureteropelvic junction obstruction: long-term outcome in 47 renal units. J Urol. 156(6):2020-4, 1996
Related Anatomy
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Related Differential Diagnoses
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References
Tables
Tables
KEY FACTS
Terminology
Imaging
Pathology
Clinical Issues
TERMINOLOGY
Abbreviations
Ureteropelvic junction (UPJ) obstruction
Synonyms
Pelviureteric obstruction
Definitions
Variable degree of blockage to urine flow at level of UPJ
Most common urinary tract obstruction in pediatrics
May be diagnosed antenatally with sonography or present in infancy or later childhood with UTI, intermittent abdominal pain, vomiting, hematuria
Occasionally found incidentally during trauma work-up
IMAGING
General Features
Radiographic Findings
Ultrasonographic Findings
Fluoroscopic Findings
CT Findings
MR Findings
Nuclear Medicine Findings
Other Modality Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Staging, Grading, & Classification
Gross Pathologic & Surgical Features
Microscopic Features
CLINICAL ISSUES
Presentation
Natural History & Prognosis
Treatment
Selected References
Senol C et al: Changes in Cajal cell density in ureteropelvic junction obstruction in children. J Pediatr Urol. 12(2):89.e1-5, 2016
Brucher N et al: Non-contrast-enhanced MR angiography using time-spin labelling inversion pulse technique for detecting crossing renal vessels in children with symptomatic ureteropelvic junction obstruction: comparison with surgical findings. Eur Radiol. 26(8):2697-704, 2015
Li R et al: Diagnosis and management of ureteral fibroepithelial polyps in children: a new treatment algorithm. J Pediatr Urol. 11(1):22.e1-6, 2015
Parikh KR et al: Pediatric ureteropelvic junction obstruction: can magnetic resonance urography identify crossing vessels? Pediatr Radiol. 45(12):1788-95, 2015
Cutroneo G et al: Altered cytoskeletal structure of smooth muscle cells in ureteropelvic junction obstruction. J Urol. 185(6):2314-9, 2011
Mei H et al: Laparoscopic versus open pyeloplasty for ureteropelvic junction obstruction in children: a systematic review and meta-analysis. J Endourol. 25(5):727-36, 2011
Samarasekera D et al: Endopyelotomy still has an important role in the management of ureteropelvic junction obstruction. Can Urol Assoc J. 5(2):134-6, 2011
Wu Z et al: Novel method for double-J stenting in retroperitoneal laparoscopic dismembered pyeloplasty. Urology. 77(2):354-6, 2011
Baek M et al: Long-term outcomes of dismembered pyeloplasty for midline-crossing giant hydronephrosis caused by ureteropelvic junction obstruction in children. Urology. 76(6):1463-7, 2010
Szavay PO et al: Functional outcome after laparoscopic dismembered pyeloplasty in children. J Pediatr Urol. 6(4):359-63, 2010
Richstone L et al: Pathologic findings in patients with ureteropelvic junction obstruction and crossing vessels. Urology. 73(4):716-9; discussion 719, 2009
VanderBrink BA et al: Reconstructive surgery for lower pole ureteropelvic junction obstruction associated with incomplete ureteral duplication. J Pediatr Urol. 5(5):374-7, 2009
Khaira HS et al: Helical computed tomography for identification of crossing vessels in ureteropelvic junction obstruction-comparison with operative findings. Urology. 62(1):35-9, 2003
Brkljacic B et al: Doppler sonographic renal resistance index and resistance index ratio in children and adolescents with unilateral hydronephrosis. Eur Radiol. 12(11):2747-51, 2002
Rooks VJ et al: Extrinsic ureteropelvic junction obstruction from a crossing renal vessel: demography and imaging. Pediatr Radiol. 31(2):120-4, 2001
Frauscher F et al: Crossing vessels at the ureteropelvic junction: detection with contrast-enhanced color Doppler imaging. Radiology. 210(3):727-31, 1999
Amling CL et al: Renal ultrasound changes after pyeloplasty in children with ureteropelvic junction obstruction: long-term outcome in 47 renal units. J Urol. 156(6):2020-4, 1996
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