What is Ureteropelvic Stenosis (UP Stenosis)? What are the Symptoms, Diagnosis and Treatment?

Ureteropelvic stenosis is called stenosis of the ureteral tubes at the kidney exit of the renal pelvis.

After the urine is made in the kidney, it joins the calyxes of the kidney from there to the pelvis of the kidney.

Urine accumulated in the pelvis passes through the ureteropelvic junction, that is, the pelvis exit of the kidney, and into the bladder via the ureteral tubes.

UP stenosis is seen in approximately 1-3% of newborns. In recent years, there has been a serious increase in the diagnosis of postnatal uterine stenosis in parallel with the increase in ultrasound evaluation in babies in the womb.

UP stenosis is the most common cause of enlargement in the kidney, i.e. hydronephrosis, after birth.

It is usually on the left side and is 2 times more common in boys than girls. 10-30% can be bilateral. Sometimes one side is narrower than the other.

UP stenosis is usually congenital. Insufficient development of the junction of ureteropelvic stenosis in the mother’s womb, crossing the UP region of the kidney vessels, that is, the crossing of the vessels, or the rise of the UP region from the renal pelvis higher than normal, may cause stenosis in the UP region.

The reason for non-congenital UP strictures is to undergo kidney and ureter surgeries or to be exposed to chronic infections such as tuberculosis.

In case of UP stenosis, urine made in the kidney is difficult to pass into the ureteric tubes. Renal pelvis enlarges and infection may occur as a result of severe thinning of the kidney due to difficulty or passage of urine. As a result, kidney failure goes.

Most of the cases manifest themselves in the womb, i.e. prenatally, as an enlargement of the kidneys on ultrasound.

The majority of these expansions regress after completing the UP-junction development.

However, if UP stenosis continues in some, kidneys may be lost if it is not treated. As a result, the first diagnostic tool is ultrasonography.

Then DMSA scintigraphy to detect kidney damage and MAG-3 synthigafi to see if the kidney is evacuated.

If there is UP stenosis in the newborn, it should be followed closely with the examinations mentioned.

UP stenosis treatment is surgical. The junction of the ureter is removed laparoscopically or openly and the ureter tube is re-anastomosed to the renal pelvis, that is, it is joined with stitches.

If there is a cross vein, the UP under the crossing vein is taken over the vein. We can say that one of the diseases in which laparoscopic surgery is most successful is the treatment of ureteropelvic stenosis.