Ureteropelvic Junction (UPJ) Obstruction: How to Care for Your Child

While some children with UPJ obstruction have no symptoms, many need surgery to protect the kidneys from damage.

Normally, urine is made in the kidneys and flows downward in tubes called ureters to the bladder, where it is stored until a person urinates (pees). The ureteropelvic (yoo-REE-tuh-roh-PEL-vik) junction (UPJ) is where the ureter meets the kidney. When a child has UPJ obstruction, urine may not pass out of the kidney as easily as it should.

The condition doesn't cause problems in some kids, but in others it can make the kidney swell with urine, leading to damage over the long term.

Most children with UPJ obstructions are born with them. Sometimes, though, UPJ obstruction develops in older kids or adults because of scar tissue, inflammation, or a kidney stone. UPJ obstruction can occur in one kidney or both.

UPJ obstruction might cause no symptoms, or it may cause pain, an area of fullness in the abdomen, nausea, vomiting, red-tinted urine from blood, a urinary tract infection (UTI), or poor growth.

Surgery may be recommended soon after UPJ obstruction is diagnosed, or a child may be watched closely to see if surgery is needed or if the obstruction will go away on its own. Antibiotics might be recommended to help prevent infections.

• If surgery will be used to repair the UPJ obstruction, talk to the health care provider about which sports or activities your child should avoid until the health care provider says it's OK to resume them.

• Give your child any recommended antibiotics as directed by the health care provider.

• Make sure to follow up with the health care provider for all recommended appointments and ultrasounds.

Your child:

• Has more redness or new redness in the urine.

• Develops a fever.

• Develops a lump in the abdomen.

• Has abdominal or back pain.

• Is vomiting.

Your child:

• Has severe abdominal or back pain.

• Is not taking fluids and appears dehydrated; signs include dizziness, drowsiness, a dry or sticky mouth, sunken eyes, producing less urine or darker than usual urine, crying with little or no tears.

• Is not urinating.