Ureterovesical junction obstruction (UVJO) is a relatively common congenital anomaly of the urinary system. It is often caused by congenital narrowing of the ureter or the presence of a ureteral valve. The condition typically lacks obvious symptoms in its early stages and is commonly discovered during the evaluation of ureteral stones or routine medical examinations. The diagnosis of UVJO requires the exclusion of structural ureteral obstructions, obstructive lesions in the lower urinary tract, and vesicoureteral reflux.
For asymptomatic UVJO patients, a watchful observation approach is generally adopted. If worsening hydronephrosis in the renal or ureteral regions, worsening kidney function, associated stone formation, or significant discomfort is identified, surgical treatment may be necessary. Surgical options include ureteral dilation, ureteral reimplantation in the bladder, or ureteroplasty with a bladder muscle flap. When the affected kidney has lost its function entirely or is associated with severe uncontrolled infection, nephroureterectomy may be considered.