Is your daily routine a constant rush to the bathroom? Those frequent washroom breaks can interfere with your work, fun with friends, and even your sleep quality. This could be a sign of ureteropelvic junction (UPJ) obstruction, which is a clog in a tiny part of your kidney that interferes with urine flow. While not everyone with UPJ obstruction experiences these problems, it’s essential to be aware of the potential impact on your daily life. If you’re little one is struggling with any of these symptoms, don’t just suffer in silence. Explore this detailed article on UPJ obstruction in babies to gain information about this urological condition.
What is Ureteropelvic Junction (UPJ) Obstruction?
The urinary system is made of two kidneys, two ureters, the bladder, and the urethra. Kidneys, the bean-shaped organs located just below the rib cage, play a vital role in producing urine and filtering waste from the blood. Ureters, thin tubes, carry urine from the kidneys to the bladder, where it’s stored until the bladder is ready to empty it. Finally, the urethra serves as the tube that releases urine from the bladder out of the body.
UPJ obstruction occurs when there’s a blockage in the renal pelvis of the kidney, which is located at the upper end of each ureter—the tubes that take urine from the kidneys to the urinary bladder. It is a congenital condition that can be seen in babies before birth. When this obstruction occurs, the kidney will fail to drain the waste properly. This results in a build-up of waste material that causes the kidneys to swell. As a result, ultrasound can easily detect the increase in size of the kidneys.
What are the Causes?
Most of the time, UPJ obstruction happens when a baby is born. It means that something didn’t grow right in the ureter or kidney when they were growing inside their mother’s belly. Sometimes, it runs in families, but usually, it only happens to one person in the family.
There are different reasons why it happens:
- The hole in the ureter is too small.
- There are problems with the muscles in the ureter that help push urine down to the bladder.
- There are abnormal folds in the ureter walls that can act like valves.
- The might be a twist in the ureter at certain places.
- The ureter connects to the kidney in the wrong way.
- Sometimes, blood vessels press on the UPJ and cause trouble.
However, causes in adults or older children can include scar tissue, past UPJ treatments, or infections. Regardless of the causes, you can always rely on the expertise and compassionate care of your doctor for your child’s upj obstruction treatment.
What are the Warning Signs?
Thanks to more prenatal check-ups, doctors can spot UPJ blockage before any signs show up. If they see any swelling in the kidney, called hydronephrosis, they’ll keep an eye on the baby during the pregnancy and after the baby’s born. After birth, they might do more tests to be sure about the blockage. However, older children might experience some symptoms of UPJ Obstruction.
- Feeling a lump in the belly
- Getting a fever from a urinary tract infection
- They may experience pain in the upper belly or back, especially after they drink something. This happens because urine can’t flow right and presses on the kidney and the area around it. Sometimes, the pain comes and goes because the blockage isn’t always complete, so urine can move sometimes. Other times, the blockage only happens when you stand up, not when you’re lying down.
- Having kidney stones
- Blood while urinating
- Vomiting
- Poor growth in infants
Diagnose Before and After A Child Birth?
When urine can’t flow right because of the blockage, the kidney swells up, which doctors can see on the ultrasound. However, early diagnosis can help keep your urinary system functioning smoothly and get you back to enjoying your life to the fullest.
After the baby’s born, the following tests are conducted to check how well urine is made and drained.
- They take some blood and urine samples, such as BUN and Creatinine, to see how well the kidneys are cleaning the blood.
- Sometimes, they also perform an intravenous pyelogram (IVP). They put a special dye into the blood and use X-rays to see how it moves through the kidney, the part where urine collects (renal pelvis), and the tube that carries urine to the bladder (ureter).
- Another test is a nuclear renal scan. In this test, a tiny bit of radioactive material is injected into the blood, and then a special camera is used to watch how the kidney works and determine whether there’s any blockage.
- They might also do ultrasound, CT scans, or MRI scans. These show if anything is blocking the kidney and also let them see how the kidneys, tubes, and bladder are shaped.
How to Treat UPJ Obstruction in Babies?
Treatment is not always necessary. In many newborns with UPJ blockage, the problem might fix itself before they’re 18 months old. During this time, a pediatric urologist monitors it with ultrasounds and scans to ensure it won’t cause any long-term issues. But if the urine still can’t flow right and the blockage persists after 18 months, then babies need surgery to fix it.
1. Open Surgery
The most common UPJ obstruction in newborn treatment is open pyeloplasty. In this surgery, the surgeon removes UPJ. First, the child is anesthetized, and then the surgeon makes a 2- to 3-inch-long incision just below the ribs. After that, they reattach the ureter to the renal pelvis to create a wider opening. This allows urine to drain and flow out quickly. The goal of open surgery is to stop the symptoms and lower the chance of infections.
2. Laparoscopic Surgery
Laparoscopy, a minimally invasive procedure, is another surgical technique used to treat UPJ obstruction in babies. In this procedure, a tiny camera and tools are used through a small cut instead of a big one.
Sometimes, they put a wire through the urine tube to reach the blockage from the inside. They use the wire to clear the blockage and put it in a drain for a few weeks while it heals. This surgery is beneficial as it doesn’t need any cuts and causes less discomfort.
Post-Treatment Protocols
Patients typically recover fairly quickly after treatment. Following surgery, the ureter may be swollen for a bit, and some children might experience pain for a few days. The kidney’s drainage might still be a bit slow initially, but it often improves as the area heals.
Sometimes, a drainage tube is left in place to help with kidney drainage while it heals. The kidney’s appearance will improve with time. Once the blocked kidney responds well to treatment, the kids can usually get back to sports and other activities.
Conclusion
In conclusion, UPJ obstruction, though primarily a medical condition, can target individuals of different ages and present a range of symptoms and complications. Through early diagnosis, vigilant monitoring, and timely intervention, you can effectively manage UPJ obstruction in babies. This can minimize its impact on kidney function and overall health. Whether it’s through simple monitoring, less invasive procedures, or surgery, the aim is clear: to restore normal urine flow, ease symptoms, and safeguard kidney health. By spreading awareness about UPJ obstruction and its treatment options, we empower patients and families to face this condition head-on, ensuring the best possible outcomes for kidney health and everyday life.