Obstructive uropathy

Obstructive uropathy is a condition in which the flow of urine is blocked. This causes the urine to back up and injure one or both kidneys.

Causes

Obstructive uropathy occurs when urine cannot drain through the urinary tract. Urine backs up into the kidneys and may cause them to become swollen. This condition is known as hydronephrosis.

Hydronephrosis

Hydronephrosis is swelling of one kidney due to a backup of urine. This problem may occur in one kidney.

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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 some of the fluid that carries sperm during ejaculation. The prostate gland surrounds the urethra, the tube th...

  

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• Advanced prostate cancer
  
• Bladder or ureteral cancer
• Bladder prolapse (also called dropped bladder)
  
• Colon cancer

  Colon cancer

  Colorectal cancer is cancer that starts in the large intestine (colon) or the rectum (end of the colon). It is also sometimes simply called colon ca...

  

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• Cervical or uterine cancer

  Cervical or uterine 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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• Ovarian cancer

  Ovarian cancer

  Endometrial cancer is cancer that starts in the endometrium, the lining of the uterus (womb).

  

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• Any cancer that spreads
• Scar tissue that occurs inside or outside of the ureters
• Scar tissue that occurs inside the urethra
• Problems with the nerves that supply the bladder

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 flank. The pain may be felt on one or both sides.
• Fever.
• Nausea or vomiting.
• Weight gain or swelling (edema) of kidney.

You may also have problems passing urine, such as:

• Urge to urinate often
• Decrease in the force of urine stream or difficulty urinating
• Dribbling of urine
• Not feeling as if the bladder is emptied
• Need to urinate more often at night
• Decreased amount of urine
• Leakage of urine (urinary incontinence)
• Blood in urine

Exams and Tests

Your health care provider will order functional or imaging studies to detect obstructive uropathy. Commonly used tests include:

• Ultrasound of the kidneys, abdomen, or pelvis

  Ultrasound of the kidneys, 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 kidneys, abdomen, or pelvis

  CT scan of the kidneys, 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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• Voiding cystourethrogram
• Renal nuclear scan
• MRI of the abdomen or pelvis
• Urodynamic test
• Cystoscopy

Treatment

Medicines may be used if the cause is an enlarged prostate.

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 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 treated 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 linked to higher chances of urinary tract infections.

When to Contact a Medical Professional

Contact your provider if you have symptoms of obstructive uropathy.

Prevention

Obstructive uropathy can be prevented by treating disorders that can cause it.