Understanding ureterovesical junction obstruction

Definition

UVJO is the result of an anatomic or a functional abnormality in the distal segment of the ureter.

Types

UVJO can be complete or partial.

The cause

The cause of potential obstruction is thought to be a segment of distal ureter that is aperistaltic.

Facts & Figures

1/2700

non-refluxing megaureters are seen.

25%

of bilateral involvement in cases.

20%

of neonatal hydronephrosis cases.

4:1

male predominance.

Diagnosing UVJO

The diagnosis is confirmed with diuretic renography and ruling out VUR with voiding cystourethrogram.

Treating UVJO

As many as 70% to 80% of non- refluxing megaureters resolve spontaneously over time, making surgical intervention for congenital UVJ obstructions rare.

Non-refluxing megaureters with delayed drainage on diuretic renography are often observed.

Surgery is indicated in decreased renal function, UTIs, or other clinical indications.
Reimplantation with ureteral remodeling is the surgical intervention.

Obstructive uropathies | 3. Mastering the treatment of obstructive uropathy
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