One of the most common pathologies detected during ultrasonography performed in the womb is swelling of the kidney (hydronephrosis). It often disappears after birth. If it continues after birth, further examination is necessary. The most important surgical cause of hydronephrosis is ureteropelvic junction stenosis, which can be described as stenosis at the junction of the kidney and the urinary tract.
Ureteropelvic junction stenosis is a problem that makes it difficult to pass urine between the kidney and the urinary tract. If ureteropelvic junction stenosis is not corrected surgically, the size of the kidney gradually increases and the thickness of the kidney tissue gradually decreases. After a while, the kidney becomes a bladder filled with urine and loses its function completely. Sometimes, due to inflammation of this kidney, life-threatening kidney infections and abscesses may occur.
Various radiological and scintigraphic examinations are performed for hydronephrosis that continues after birth. These examinations determine whether there is ureteropelvic junction stenosis and its degree. Therefore, close monitoring is necessary.
It usually does not cause any serious complaints after birth. Sometimes it can be felt as a soft abdominal mass by the family or the attending physician. Diagnosis is made by ultrasonography. Ultrasound shows a swollen kidney with thinned walls, while the bladder and urinary tract are normal. Kidney function is evaluated with scintigraphic methods.
Treatment Treatment is generally planned according to the degree of hydronephrosis detected on urinary ultrasound, kidney damage detected on scintigraphy, the presence of urinary infection and whether the hydronephrosis is unilateral or bilateral. If kidney swelling worsens, there is loss of kidney function, if there is a urinary tract infection and/or stone formation, a surgical treatment decision is made.
Once ureteropelvic junction stenosis is diagnosed, surgery is planned. During the surgery, the narrow part where the kidney meets the urinary tract is removed and the kidney and urinary tract are stitched together.
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