Morphological Changes of Ureteropelvic Junction (UPJ) in Case of Congenital Hydronephrosis – Review of Literature

Congenital hydronephrosis is the most common cause of antenatally detected hydronephrotic transformation. Obstruction of UPJ can be intrinsic or extrinsic. Most cases of intrinsic stenosis do not require any treatment as it disappears during growth of a child. It is considered that in these cases wave of peristalsis appears again in aperistaltic UPJ. The cells responsible for peristalsis wave impulses, mechanisms of conduction of these impulses and regulation of them are not well recognized. Similarly, it is not clear why functional UPJ stenosis appears and disappears untreated in most cases. Researchers believe that all these processes are associated with the structural peculiarities of UPJ - changes in urothelium, muscle layer and innervation. The role of interstitial cells of Cajal (ICCs), important contributors of the urinary tract physiology, has not been extended to the obstruction of UPJ. Structural changes of UPJ wall are conclusive while choosing the most appropriate method of surgical treatment in newborns with congenital hydronephrosis.