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Obstructive uropathy
Uropathy - obstructive
Obstructive uropathy is a condition in which the flow of urine is blocked. This causes the urine to back up back up and injure one or both kidneys.
Causes
Obstructive uropathy occurs when urine cannot drain through a ureter (a tube that carries urine from the kidneys to the bladder). Urine backs up into the kidney and causes it to become swollen ( hydronephrosis ).
Hydronephrosis
Hydronephrosis is swelling of one kidney due to a backup of urine. This problem may occur in one kidney.
Obstructive uropathy can affect one or both kidneys. It can occur suddenly, or be a long-term problem.
Common causes of obstructive uropathy include:
-
Bladder stones
Bladder stones
Bladder stones are hard buildups of minerals. These form in the urinary bladder.
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Kidney stones
Kidney stones
A kidney stone is a solid mass made up of tiny crystals. One or more stones can be in the kidney or ureter at the same time.
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Benign prostatic hyperplasia
(enlarged prostate)
Benign prostatic hyperplasia
The prostate is a gland that produces the fluid that carries sperm during ejaculation. The prostate gland surrounds the urethra, the tube through wh...
ImageRead Article Now Book Mark Article - Bladder or ureteral cancer
-
Colon cancer
Colon cancer
Colon, or colorectal cancer, is cancer that starts in the large intestine (colon) or the rectum (end of the colon). Other types of cancer can affect ...
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Cervical cancer
Cervical cancer
Cervical cancer is cancer that starts in the cervix. The cervix is the lower part of the uterus (womb) that opens at the top of the vagina.
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Uterine cancer
Uterine cancer
Endometrial cancer is cancer that starts in the endometrium, the lining of the uterus (womb).
ImageRead Article Now Book Mark Article - Any cancer that spreads
- Scar tissue that occurs inside or outside of the ureters
- Problems with the nerves that supply the bladder
Rarely, the problem occurs during pregnancy. This condition is called idiopathic hydronephrosis of pregnancy.
Symptoms
Symptoms depend on whether the problem starts slowly or suddenly, and if one or both kidneys are involved. Symptoms may include:
- Mild to severe pain in the side of the body and the back (flank pain). The pain may be felt on one or both sides.
- Fever
- Nausea or vomiting
- Weight gain or swelling (edema)
You may also have problems passing urine, such as:
- Urge to urinate often
- Decrease in the force of urine stream
- Dribbling of urine
- Not feeling as if the bladder is emptied
- Need to urinate more often at night
- Decreased amount of urine
- Blood in urine
Exams and Tests
Imaging studies are done to diagnose obstructive uropathy. Commonly used tests include:
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Ultrasound of the belly area (abdomen)
or pelvis
Ultrasound of the belly area (abdomen)
Abdominal ultrasound is a type of imaging test. It is used to look at organs in the abdomen, including the liver, gallbladder, spleen, pancreas, and...
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CT scan of the belly area (abdomen)
or pelvis
CT scan of the belly area (abdomen)
An abdominal CT scan is an imaging method. This test uses x-rays to create cross-sectional pictures of the belly area. CT stands for computed tomog...
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Intravenous pyelogram (IVP)
Intravenous pyelogram (IVP)
An intravenous pyelogram (IVP) is a special x-ray exam of the kidneys, bladder, and ureters (the tubes that carry urine from the kidneys to the bladd...
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- Renal nuclear scan
- MRI
Treatment
Stents or drains placed in the ureter or in a part of the kidney called the renal pelvis may provide short-term relief of symptoms.
Nephrostomy tubes, which drain urine from the kidneys through the back, may be used to bypass the blockage.
A Foley catheter, placed through the urethra into the bladder, may also be help urine flow.
Short-term relief from the blockage is possible without surgery. However, the cause of the blockage must be removed and the urinary system repaired. Surgery may be needed for long-term relief from the problem.
The kidney may need to be removed if the blockage causes severe loss of function.
Outlook (Prognosis)
If the blockage comes on suddenly, kidney damage is less likely if the problem is detected and repaired right away. Often, the damage to the kidneys goes away. Long-term damage to the kidneys may occur if the blockage has been present for a long time.
If only one kidney is damaged, chronic kidney problems are less likely.
You may need dialysis or a kidney transplant if there is damage to both kidneys and they do not function, even after the blockage is repaired.
Possible Complications
Obstructive uropathy can cause permanent and severe damage to the kidneys, resulting in kidney failure.
If the problem was caused by a blockage in the bladder, the bladder may have long-term damage. This may lead to problems emptying the bladder or leakage of urine.
Obstructive uropathy is associated with a higher likelihood of urinary tract infections.
When to Contact a Medical Professional
Call your health care provider if you have symptoms of obstructive uropathy or suspect you may have this condition.
Prevention
Obstructive uropathy can be prevented by treating disorders that can cause it.
References
Meldrum KK. Pathophysiology of urinary tract obstruction. In: Wein AJ, Kavoussi LR, Partin AW, Peters CA, eds. Campbell-Walsh Urology . 11th ed. Philadelphia, PA: Elsevier; 2016:chap 48.
Zeidel ML. Obstructive uropathy. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine . 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 123.
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Bladder catheterization, female - illustration
A catheter (a hollow tube, often with an inflatable balloon tip) may be inserted into the urinary bladder when there is a urinary obstruction, following surgical procedures to the urethra, in unconscious patients (due to surgical anesthesia, coma, or other reasons), or for any other problem in which the bladder needs to be kept empty (decompressed) and urinary flow assured. The balloon holds the catheter in place for a duration of time.
Bladder catheterization, female
illustration
-
Bladder catheterization, male - illustration
Catheterization is accomplished by inserting a catheter (a hollow tube, often with and inflatable balloon tip) into the urinary bladder. This procedure is performed for urinary obstruction, following surgical procedures to the urethra, in unconscious patients (due to surgical anesthesia, coma, or other reasons), or for any other problem in which the bladder needs to be kept empty (decompressed) and urinary flow assured. The balloon holds the catheter in place for a duration of time. Catheterization in males is slightly more difficult and uncomfortable than in females because of the longer urethra.
Bladder catheterization, male
illustration
-
Female urinary tract - illustration
The female and male urinary tracts are relatively the same except for the length of the urethra.
Female urinary tract
illustration
-
Male urinary tract - illustration
The male and female urinary tracts are relatively the same except for the length of the urethra.
Male urinary tract
illustration
-
Bladder catheterization, female - illustration
A catheter (a hollow tube, often with an inflatable balloon tip) may be inserted into the urinary bladder when there is a urinary obstruction, following surgical procedures to the urethra, in unconscious patients (due to surgical anesthesia, coma, or other reasons), or for any other problem in which the bladder needs to be kept empty (decompressed) and urinary flow assured. The balloon holds the catheter in place for a duration of time.
Bladder catheterization, female
illustration
-
Bladder catheterization, male - illustration
Catheterization is accomplished by inserting a catheter (a hollow tube, often with and inflatable balloon tip) into the urinary bladder. This procedure is performed for urinary obstruction, following surgical procedures to the urethra, in unconscious patients (due to surgical anesthesia, coma, or other reasons), or for any other problem in which the bladder needs to be kept empty (decompressed) and urinary flow assured. The balloon holds the catheter in place for a duration of time. Catheterization in males is slightly more difficult and uncomfortable than in females because of the longer urethra.
Bladder catheterization, male
illustration
-
Female urinary tract - illustration
The female and male urinary tracts are relatively the same except for the length of the urethra.
Female urinary tract
illustration
-
Male urinary tract - illustration
The male and female urinary tracts are relatively the same except for the length of the urethra.
Male urinary tract
illustration
Review Date: 3/28/2016
Reviewed By: Scott Miller, MD, urologist in private practice in Atlanta, GA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.
