Congenital UPJ obstruction can present at any time, from intrauterine life to old age. With the increased use of prenatal ultrasound, a number of infants are found to have hydronephrosis. UPJ obstruction is one of the most common causes of prenatal hydronephrosis.
In adults, the majority present with flank pain that can be associated with nausea. Others may present with hematuria, urinary tract infections, stone disease, or vague gastrointestinal complaints. Radiographic evidence plays a key role in the diagnosis of UPJ obstruction. In our opinion, the best radiographic study is a diuretic intravenous pyelogram (2). Other useful studies include radionuclide renal scans, computed tomography, ultrasonography, and retrograde pyelography. The diagnosis of UPJ obstruction is based on the combination of clinical manifestations, radiographic evidence of obstruction and impairment of renal function.