VesicoUreteric Junction (VUJ)
Obstruction
What
is
it?
What
tests
are
performed?
Vesicoureteric
junction
obstruction
(VUJO)
refers
Ultrasound
to
a
restriction
to
urine
flow,
where
the
ureter
This
is
the
same
type
of
scan
used
during
(drainage
tube
from
the
kidney)
meets
the
pregnancy.
It
is
able
to
demonstrate
the
dilatation
bladder.
of
the
urinary
system,
identifying
the
ureters
throughout
their
length,
and
to
measure
the
What
causes
it?
degree
of
dilatation.
The
ultrasound
is
able
to
assess
the
state
of
the
kidney
and
bladder
as
well.
Most
commonly,
there
is
a
narrowed
and
stiff
section
of
ureter,
just
as
it
enters
the
bladder.
Micturating
cystourethrogram
(MCU)
Sometimes,
there
are
too
many
circular
(round)
This
test
helps
to
determine
whether
the
muscle
fibres
in
this
section
that
squeeze
the
dilatation
of
the
ureter
is
due
to
reflux
(backflow)
bottom
end
of
the
ureter
and
stop
it
draining
of
urine
from
the
bladder,
rather
than
obstruction
properly.
(see
MCU
sheet
for
more
information)
Nuclear
medicine
Who
gets
it?
Renal
scans
help
to
determine
the
relative
VUJ
obstruction
is
identified
in
about
1
per
1500-‐ function
of
the
two
kidneys,
and
may
provide
2000
newborns.
It
usually
occurs
without
other
information
about
drainage.
These
studies
should
abnormalities.
be
performed
in
a
paediatric
centre
to
obtain
the
best
results.
A
small
amount
of
radioactive
material
is
injected
into
the
child’s
bloodstream
How
does
it
present?
and
a
special
camera
takes
pictures
of
the
kidneys,
recording
the
material
passing
through
When
there
is
a
blockage
or
impairment
of
urine
and
draining
from
the
kidneys.
flow,
the
urine
builds
up
behind
the
blockage.
This
means
that
the
upper
part
of
the
ureter
becomes
distended,
all
the
way
up
to
the
collecting
system
What
are
the
treatment
options?
of
the
kidney.
This
is
commonly
picked
up
on
an
ultrasound
scan
performed
during
pregnancy
(See
Many
VUJ
obstructions
are
diagnosed
before
antenatal
hydronephrosis
information
sheet).
birth,
so
most
of
these
children
are
healthy
and
have
no
symptoms.
Many
of
them
will
If
dilatation
has
not
been
identified
before
birth,
spontaneously
correct
with
time,
so
factors
such
VUJ
obstruction
may
present
with:
as
kidney
function
and
degree
of
dilatation
- urinary
tract
infection
influence
whether
any
treatment
is
required.
- abdominal
or
flank
pain
Indications
for
intervention
- abdominal
mass
or
swelling
- urinary
tract
infections
- urolithiasis
(stones
in
the
urinary
tract)
- incidentally
(found
on
ultrasound
performed
- increasing
dilatation
for
another
reason)
- reduction
in
function
of
the
associated
kidney
This
information
sheet
is
for
educational
purposes
only.
Please
consult
with
your
doctor
or
other
health
professional
to
make
sure
this
information
is
valid
for
your
child
VesicoUreteric Junction (VUJ)
Obstruction
Intervention
options
Placement
of
temporary
stent
across
the
obstruction
can
protect
the
kidney
function
while
the
baby
is
growing
to
“buy
time”
while
natural
improvement
has
a
chance
to
occur.
In
some
cases
surgical
treatment
may
be
necessary,
excising
the
blocked
part
of
the
ureter
and
reimplanting
the
good
ureter
into
the
bladder
(see
ureteric
reimplantation
sheet).
In
some
severe
cases,
‘diversion’
is
necessary
in
the
short
term,
making
a
‘stoma’
or
direct
connection
between
the
blocked
ureter
and
skin
to
allow
complete
decompression
of
the
affected
system.
a
ureteric
reimplantation
would
then
be
undertaken
some
time
later,
when
the
child
and
bladder
are
bigger,
and
the
ureter
less
distended.
What
are
the
outcomes?
In
up
to
a
half
of
children
with
VUJ
obstruction,
the
dilatation
improves
by
itself.
In
just
over
a
third
of
patients,
the
dilatation
will
stay
the
same
without
deteriorating.
In
10-‐20%
of
children,
surgery
is
performed
for
deteriorating
kidney
function,
or
persistent
urinary
tract
infections.
What
is
the
follow-‐up?
The
doctors
will
review
your
child
regularly
with
repeated
ultrasound
scans.
Nuclear
medicine
studies
to
monitor
function
may
be
arranged
by
your
paediatric
urologist.
This
information
sheet
is
for
educational
purposes
only.
Please
consult
with
your
doctor
or
other
health
professional
to
make
sure
this
information
is
valid
for
your
child
