In older children, UPJ obstruction may be an extrinsic problem caused by compression of crossing vessels. Symptoms in these children can include nausea, vomiting, abdominal-flank pain, urinary tract infection and hematuria.
In lower grade obstructions, immediate surgery may not be necessary. If the obstruction is not causing loss of kidney function or pain, observation and monitoring may be indicated.
Because prolonged high-grade blockage, particularly with infection, can be harmful to the kidney, surgery is necessary to treat kidney from further damage. Kidney stones, failure to thrive, recurrent urinary tract infections or loss of kidney function are indications for surgery.