Disorders of the Ureter & Ureteropelvic Junction
The ureter is a tube whose only job is to carry urine downhill — so its disorders are essentially about obstruction at points along its length, and the consequence is always the same upstream: hydronephrosis.
The big picture
The ureter is a tube whose only job is to carry urine downhill — so its disorders are essentially about obstruction at points along its length, and the consequence is always the same upstream: hydronephrosis, and eventually renal damage if unrelieved. The most important entity is ureteropelvic junction (UPJ) obstruction, the commonest congenital obstruction of the upper tract. Recognise the level, prove the obstruction is functionally significant, and relieve it.
The framework: UPJ obstruction (the headline), megaureter, retroperitoneal fibrosis, and ureteric strictures — each an obstruction at a level, each threatening the kidney above it.
Mechanism pathway
Tap any step to see why it happens.
Diagnostic algorithm
Each step answers one question. Tap to expand.
Board traps
UPJ obstruction = hydronephrosis with a normal ureter below; treated by pyeloplasty.
Operate on UPJ obstruction only when it's functionally significant (diuretic renogram), not for dilation alone.
Megaureter must be classified (obstructive/refluxing/neither) before deciding to intervene.
Retroperitoneal fibrosis deviates ureters medially and may be malignant — seek the cause.
Unrelieved ureteric obstruction damages the kidney above — the constant theme.