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Ureteropelvic Junction (UPJ) Banner

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Ureteropelvic Junction (UPJ)


Your ureter is a long, thin foot-long tube that carries urine from your kidney to your bladder. In the case of ureteropelvic junction a blockage exists at the point where the ureter meets the kidney. The blockage results in decreased urine flow and increased fluid pressure inside the kidney. Over time the increased pressure can cause the kidney function to deteriorate. Ureteropelvic junction can be an inherited condition or can be caused by physical trauma.



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Risk Factors and Symptoms


UPJ is more commonly found in children than adults and is typically an inherited condition. UPJ in adults is typically the result of:
  • upper urinary tract inflammation
  • tumor in the urinary tract
  • kidney stones
  • surgical injury
  • scarring from past surgery
Symptoms can include:
  • intermittent pain at the blockage site, especially after drinking a lot of fluids
  • kidney stones
  • high blood pressure
  • blood in the urine
  • frequent urinary tract infections
  • abdominal mass
  • high fever with urinary tract infection

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Diagnostic Tests


To diagnose UPJ your urologist will perform a physical exam, review and discuss your symptoms as well as your family history, and then may order one or more of the following tests:
  • CT (computed tomography) scan – during this procedure a radiology technologist programs a large circular-shaped scanner so that it moves painlessly over your body as you lie on an exam table. You will need to remain very still and you may hear loud buzzing noises or “clicks” as the scanner sends x-rays through the area of your body that your doctor wants to study. If your doctor orders a contrast study a nurse will insert a small IV in your arm to deliver a harmless dye to your kidneys. The contrast dye will help any masses in your pelvic area be easier to visualize. The CT images are compiled on a computer which your doctor can then review. The exam should only take 15-30 minutes. Following the exam the IV will be removed and you can resume your normal activities. If you had a contrast IV you should drink a lot of fluid to help flush it out of your system.
  • MRI (magnetic resonance imaging) scan – during this procedure you will be slowly and painlessly moved through a machine that uses a magnetic field and radio waves to send digital images of your kidneys and surrounding area to a computer monitor. You may need to fast for several hours before the test and will need to let the radiologist know if you have an intrauterine device (IUD), have medical allergies, have a fear of confined spaces (if you are not using an open MRI device), if you wear medicine patches, have metal implants or could be pregnant. You will wear a hospital gown for the procedure and may hear loud “tapping” noises. You will be asked to hold your breath for a few moments while the radiologist captures specific images. The test may take only 15-30 minutes but the entire appointment may take up to an hour. There are normally no side effects and you can resume your normal daily activities after the appointment.
  • renal sonogram or ultrasound – a renal sonogram or ultrasound is a painless procedure where a radiologist or trained technician gently presses a wand across your kidney area. The wand sends sound waves into your body which bounce off your organs and the echoes create a picture of your kidneys and surrounding tissues. The image is viewed by the radiologist or technician on a computer screen.

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Treatment Options


If you are diagnosed with UPJ your doctor may recommend surgery to bypass the obstruction, a procedure known as pyeloplasty.
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