5.3 Treatment

5.3.1 UPJ-stenosis

Symptomatic UPJ-stenosis requires surgical correction, whereas asymptomatic unilateral UPJ-stenosis can be subjected to surveillance depending on the grade of obstruction and split renal function. If function does not improve within 3-6 months in patients with a renal function of less than 10% on the affected side, nephrectomy should be considered, especially when symptoms occur (e.g. UTI, hypertension, flank pain). Patients with a function of less than 40% should undergo pyeloplasty. If the partial function is greater than 40%, operative intervention is indicated only if new symptoms occur or function drops more than 10% with time. Sonography should be performed every 4 weeks. Renal function scintigraphy must be repeated within 1 year. Children with a pre-operative partial function below 45% show enhanced growth and an improved overall renal function post-operatively.