Double Obstruction in Pediatric UPJO: When One Diagnosis Is Not Enough

Not every child with hydronephrosis has a single obstructed point. In rare cases, UPJO and distal ureterovesical junction obstruction coexist in the same drainage system.This episode explores how double obstruction can be missed, why hydroureter should change the diagnostic pathway, and why treating only one level may leave the kidney obstructed.The central idea: double obstruction is a two-gate problem. Opening one gate may not restore drainage if the other remains closed.Keywords: UPJO, UVJO, primary obstructive megaureter, pyeloplasty, hydronephrosis, pediatric urology.