(Narrow Renal Pelvis)

(Narrow kidney pelvis)
What does UPJO mean ?

UPJ0 or Kidney pelvis narrowing is the presence of a narrow segment at the junction between the renal pelvis and the ureter , this narrowing may slow the movement of urine from the kidneys to the ureters and sometimes stop its descent completely, which results in repeated infections in the kidneys and in some cases these infections may lead to Kidney tissue damage.

What are the causes of UPJO?

  • The main cause in most cases of narrowing of the renal pelvis is a genetic cause where the child is born narrow in the kidney pelvis, and therefore most of these cases are diagnosed during pregnancy during the periodic examination of the expectant mother by Ultrasound, which requires a visit to a urologist immediately after birth To treat this narrowing quickly to avoid any complications of this narrowing.
  • in audits, the narrowing of the renal pelvis may be due to the presence of kidney stones.
  • The narrowing of the renal pelvis may result from performing some kidney surgeries.

Symptoms:
in children, most cases are discovered before birth or immediately after birth without the appearance of any symptoms, but if the case is NOT diagnosed Antenatally ( before birth ) , there are several symptoms that appear on children
and adults, the most important of which are:

  • Having a mass in the abdomen
  • Frequent urinary tract infections
  • Renal colic and pain in the kidneys
  • Kidney stones
  • blood in urine
  • continuous vomiting
  • in children, lack of proper growth

Diagnosis:

  • Ultrasound
  • intravenous Urography ( x-Rays with contrast )
  • CT scan ( with or without contrast )
  • isotope Renal scan to determine the presence or absence of narrowing and its effect on the kidney tissue and the efficiency of its Function

treatment:

Most children who suffer from UPJ0 may not need any treatment and may only need to follow up their kidney function through periodic laboratory and Radiological investigations, and their condition may improve during the first year and a half of their life.

As for the cases that require treatment, the:

treatment options include

1–Surgical Repair

And during which the narrow part is removed and the ureter and the Renal pelvis are reconnected naturally and in a way that allows urine to descend in its natural course. In some cases, a stent placement is required which is usually removed 2 or months after surgery

2- Laparoscopic Repair

it is a method similar to traditional surgery, but the excision of the narrow area is done through Laparoscopy.

3-Endoscopic Management using Laser

Where the endoscope is inserted from the urethral opening in order to treat the narrowing using a laser. is preferable to use this method in cases that have had previous unsuccessful surgery or in the case of a small narrowing that does not require surgery.