Obstructive Genitourinary Defect
Obstructive genitourinary defects are congenital narrowing or absence of urinary tract structures. These conditions are the most common congenital defect of any organ system. The severity of the problems for the child depends on the degree and level of the obstruction. For example, the most common type of obstruction is at the uteropelvic junction (UPJ), an obstruction that occurs between the ureter and the kidney at the place they join. Due to this obstruction urine does not easily pass through the ureter and consequently it backs up through the renal system. The second most common obstruction is where the ureter enters the back wall of the bladder, the ureterovesicular junction (UVJ). UVJ obstruction, which usually involves only one kidney, will result in backflow and enlargement of the ureter (called megaureter).
Any type of urinary tract obstruction will interfere with normal fetal development, and the degree of damage depends on the severity of the obstruction. The spectrum of fetal injury depends on the type, degree and duration of the obstruction. In unborn babies with high-grade obstruction, urine output is decreased, leading to lack of amniotic fluid (called oligohydramnios). The lungs also will not develop properly due to the lack of amniotic fluid. Hydronephrosis, which is kidney damage, is a frequent result of an obstruction in the urinary system. Our program has been tracking obstructive genitourinary defect (renal pelvis and ureter only) among live births in select counties since 2005 and are gradually expanding statewide.
- Using data from births to Hennepin and Ramsey county residents between 2012-2016, we found that 69.9 babies were born with obstructive genitourinary defect (renal pelvis and ureter only) per 10,000 births.
- Using this data, we estimate about 239 babies are born with obstructive genitourinary defect (renal pelvis and ureter only) every year in Minnesota.
Parental education and support are essential, and local, regional and national organizations may be very helpful.