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Uretero-pelvic junction stenosis (JUP), also called obstruction of the pyeloureteral junction, is an obstruction of the urinary tract, where a piece of the ureter, the channel that carries urine from the kidneys to the bladder, is thinner than the normal, causing the urine not to flow properly into the bladder, accumulating in the kidneys.
JUP is usually diagnosed even during pregnancy or shortly after birth as it is a congenital condition, which allows the appropriate treatment to be done as soon as possible, and reduces the likelihood of kidney overload, and consequently the loss of kidney function.
Some signs of JUP stenosis include swelling, pain and recurrent urinary infections, which can lead in severe cases to loss of the affected kidney, so the recommended treatment is surgery.
Main symptoms
The symptoms of JUP stenosis can appear in childhood, however it is not uncommon for them to manifest in adolescence or adulthood. The most common symptoms can be:
- Swelling on one side of the belly or back;
- Formation of kidney stones;
- Recurrent urinary tract infection;
- Pain in one side of the back;
- Arterial hypertension;
- Blood in the urine.
Confirmation of suspected JUP is made by imaging tests, such as renal scintigraphy, X-rays and ultrasounds, which are used to differentiate between significant obstruction, when urine cannot pass from the kidney to the bladder and which requires surgical correction, of dilation renal pielocalicial, which is a swelling of the kidney for example, in which surgery is not indicated. Check out what is the pyelocalyal dilation and how the treatment is done.
If JUP is suspected, it is important to see a nephrologist, as delayed diagnosis can lead to loss of the affected kidney.
What causes JUP stenosis
The causes of JUP stenosis are still unknown, but in most cases it is a congenital problem, that is, the person is born that way. However, there are causes of JUP obstruction that can also be triggered by kidney stones, blood clots in the ureter or schistosomiasis, for example.
In rare cases, the reason for the stenosis may be due to trauma to the abdomen, such as blows, or accidents that involve a large impact in that region.
How the treatment is done
The treatment for JUP stenosis is done by surgery called pieloplasty, and aims to reestablish the normal flow of urine between kidney and ureter. The surgery lasts two hours, general anesthesia is used, after approximately 3 days of hospitalization the person can return home, and in most cases the kidney is able to recover from the injury it has suffered.
Is it possible to get pregnant?
JUP stenosis does not affect fertility, so it is possible to become pregnant. However, it is necessary to check the degree of kidney damage, if the woman has high blood pressure or if the levels of proteinuria are high. If these values are changed, there is a greater risk of problems in pregnancy, such as premature birth or maternal death, and therefore pregnancy may be advised against by the nephrologist.