Bladder catheterization, male
Bladder catheterization, male
Female urinary tract
Female urinary tract
Male urinary tract
Male urinary tract

Obstructive uropathy

Definition:
Obstructive uropathy involves a blockage of the flow of urine, causing it to back up and injure one or both kidneys.

Alternative Names:
Uropathy - obstructive

Causes, incidence, and risk factors:
Obstructive uropathy occurs when urine cannot drain through a ureter because of an obstruction, often ureteral or kidney stones. Urine backs up into the kidney and causes distention of the renal pelvis and calyces (hydronephrosis).

Obstructive uropathy is further differentiated by whether it affects one or both kidneys (unilateral or bilateral) and whether it occurred suddenly (acute) or developed slowly (chronic):

Common causes of obstructive uropathy include the following:

Symptoms:

Symptoms associated with obstructive uropathy vary depending on whether the obstruction is acute or chronic, whether it is unilateral or bilateral, whether it is complete or partial, and what caused it. Common symptoms of obstructive uropathy include the following:

Signs and tests:

The diagnosis of obstructive uropathy is made on imaging studies. Common radiographic studies used to diagnose obstructive uropathy include:

Treatment:

Stents or drains placed in the ureter or in 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 obstruction. A Foley catheter, inserted through the urethra, may also be helpful.

Although temporary relief from the obstruction can be achieved without surgery, the cause of the obstruction must be removed and the urinary system repaired. Long-term relief from obstructive uropathy requires surgery.

Expectations (prognosis):

If acute obstruction is rapidly diagnosed and repaired, renal damage is minimal or reversible -- regardless of being unilateral or bilateral. If chronic unilateral obstruction is not relieved promptly there could be permanent damage to the kidney. Chronic unilateral obstruction usually does not cause renal insufficiency or failure because most patients have normal function from the other kidney.

Chronic bilateral obstruction may lead to renal insufficiency or failure because both kidneys may become damaged and fail to function even after obstruction is repaired.

Complications:

Obstructive uropathy can cause permanent and severe damage to the kidneys, resulting in renal failure. Obstructive uropathy caused by bladder outlet obstruction can lead to permanent and severe damage to the bladder, resulting in problems such as incontinence, urinary retention.

Calling your health care provider:

Contact your health care provider if you have symptoms of obstructive uropathy or believe that you may be suffering from this condition.

Prevention:

Obstructive uropathy can be prevented by preventing the disorders that cause it.


Review Date: 5/25/2002
Reviewed By: Young Kang, M.D., Department of Urology, Columbia University College of Physicians and Surgeons, New York, NY. Review provided by VeriMed Healthcare Network.
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