Table of ContentsView AllTable of ContentsHow It HappensCausesSymptomsDiagnosisTreatmentPrognosis
Table of ContentsView All
View All
Table of Contents
How It Happens
Causes
Symptoms
Diagnosis
Treatment
Prognosis
Aureterovesical junction(UVJ) obstruction is a blockage of the urinary tract at the junction where the ureter—the thin tube that drains urine from thekidney—joins thebladder. In most cases, UVJ obstruction is the result of a fetal defect that can be detected on aprenatal ultrasound. Less commonly, a person may develop a blockage later in life due to disease, infection, or injury.
A UVJ obstruction in an infant usually resolves on its own. If it does not, the backflow of urine into the ureter and kidney can cause pain and potentially serious complications, includingkidney stones. If a serious obstruction, the condition can usually be effectively treated with surgery.
This article will explain how a utererovesical junction obstruction affects the urinary tract. It also describes the causes and symptoms of a UVJ obstruction, including how the condition is diagnosed and treated.
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How Ureterovesical Junction Obstructions Affect the Urinary Tract
The upper urinary tract is made up of two bean-shaped organs called kidneys that pass urine to the bladder via two narrow tubes called ureters. The junction between the bladder and each ureter is called the utererovesical junction (UVJ), also knownvesicoureteric junction.
If there is a defect in the UVJ, the flow of urine can sometimes become blocked and, instead of passing urine to the bladder, it will reflux (backflow) into the ureter and kidney. This can cause the ureter and kidney to dilate (widen) and swell.
The swelling of the ureter is calledhydroureter, while the swelling of the kidney is referred to ashydronephrosis.
How to Keep Your Urinary System Healthy
Causes of Ureterovesical Obstruction
Most cases of UVJ obstruction arecongenital, meaning that it develops while the fetus is in theuterus.
There are several reasons for this might occur:
UVJ obstruction is more common in boys than girls and tends to affect the left ureter and kidney.
Acquired UVJ Obstruction
UVJ is less common later in life but can occur when there is either the ureter is compressed externally (called extrinsic UVJ) or the ureter is blocked internally (intrinsic UVJ)
Extrinsic causes of UVJ include:
Intrinsic causes of UVJ include:
Symptoms of Ureterovesical Junction Obstruction
With that said, if not diagnosed early, or if the cause is acquired, UVJ obstruction can cause potentially severe symptoms like:
Congenital UVJ obstruction is often detected during a routineprenatal ultrasound. This non-invasive imaging study can visualize fetal organs using reflected sound waves. Onultrasound, the ureter and/or kidney of the fetus will show visible signs of hydroureter and hydronephrosis.
With congenital UVJ obstruction, the condition will usually be unilateral (one-sided), favoring the left side. However, up to 25% of cases will be bilateral (two-sided).
Additional tests may be performed after delivery to evaluate the severity of the obstruction and direct the treatment plan.
Tests commonly used to diagnose congenital and acquired UVJ obstruction include:
Treatment for Ureterovesical Junction Obstruction
During this time, pediatricians may take a watch-and-wait approach, during which RBUS and blood tests are routinely performed. The child may also be placed onantibioticsto help prevent UTIs.
Surgery
If kidney function severely declines, medical intervention may needed. This typically involves a surgery calledureteral reimplantation.
Ureteral reimplantation is performed undergeneral anesthesiaand involves the removal (resection) of the abnormal part of the ureter and the attachment (reimplantation) of the cut ends. Ureteral reimplantation can be performed asopen,laparoscopic, orrobotic surgery.
If the child is too young to undergo reimplantation, a surgical procedure calledureterostomymay be used to temporarily redirect the flow of urine out of the body through an opening in the abdomen. When the child is old enough to undergo surgery (usually around 6 to 18 months), the ureterostomy is reversed so that the child can pee normally.
In adults, UVJ obstruction is more commonly treated withpyeloplastyin which the blockage is removed and the ureter is surgically reconstructed.
The prognosis for UVJ obstruction is generally good as the vast majority of kids will outgrow the condition without treatment. However, if the obstruction is undiagnosed or left unmonitored, it can sometimes lead to a severe obstruction, resulting inkidney failureand even death.
This concern is arguably greater in people with acquired UVJ obstruction as they may not seek care until the symptoms and kidney injury are severe. The recognition of the signs of UVJ obstruction can lead to early diagnosis and treatment, improving outcomes.
Summary
If a UVJ obstruction is severe, surgery can be performed to either remove the abnormal section of the ureter or the blockage inside the ureter.
3 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Garriboli M, Berrettini A, Maraboschi I.Ureterovesical junction obstruction. In:Pediatric Surgery. Berlin: Springer, Berlin; 2023. doi:10.1007/978-3-662-43567-0_176O’Sullivan NJ, Anderson S.Pelviureteric junction obstruction in adults: a systematic review of the literature.Curr Urol.2023 Jun;17(2):86–91. doi:10.1097/CU9.0000000000000154University of California Invine.Ureterovesical junction obstruction.Additional ReadingBoston Children’s Hospital.Ureteral surgery.Children’s Health.Pediatric robotic assisted laparoscopic ureteral reimplant.
3 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Garriboli M, Berrettini A, Maraboschi I.Ureterovesical junction obstruction. In:Pediatric Surgery. Berlin: Springer, Berlin; 2023. doi:10.1007/978-3-662-43567-0_176O’Sullivan NJ, Anderson S.Pelviureteric junction obstruction in adults: a systematic review of the literature.Curr Urol.2023 Jun;17(2):86–91. doi:10.1097/CU9.0000000000000154University of California Invine.Ureterovesical junction obstruction.Additional ReadingBoston Children’s Hospital.Ureteral surgery.Children’s Health.Pediatric robotic assisted laparoscopic ureteral reimplant.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Garriboli M, Berrettini A, Maraboschi I.Ureterovesical junction obstruction. In:Pediatric Surgery. Berlin: Springer, Berlin; 2023. doi:10.1007/978-3-662-43567-0_176O’Sullivan NJ, Anderson S.Pelviureteric junction obstruction in adults: a systematic review of the literature.Curr Urol.2023 Jun;17(2):86–91. doi:10.1097/CU9.0000000000000154University of California Invine.Ureterovesical junction obstruction.
Garriboli M, Berrettini A, Maraboschi I.Ureterovesical junction obstruction. In:Pediatric Surgery. Berlin: Springer, Berlin; 2023. doi:10.1007/978-3-662-43567-0_176
O’Sullivan NJ, Anderson S.Pelviureteric junction obstruction in adults: a systematic review of the literature.Curr Urol.2023 Jun;17(2):86–91. doi:10.1097/CU9.0000000000000154
University of California Invine.Ureterovesical junction obstruction.
Boston Children’s Hospital.Ureteral surgery.Children’s Health.Pediatric robotic assisted laparoscopic ureteral reimplant.
Boston Children’s Hospital.Ureteral surgery.
Children’s Health.Pediatric robotic assisted laparoscopic ureteral reimplant.
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