Obstructive uropathy involves a blockage of the flow of urine, causing it to back up and injure one or both kidneys.
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 ):
Chronic unilateral obstructive uropathyChronic bilateral obstructive uropathyAcute unilateral obstructive uropathyAcute bilateral obstructive uropathy Common causes of obstructive uropathy include the following: Urinary tract stones Ureteral stones Bladder stones Urinary tract tumors Retroperitoneal fibrosisBenign prostatic hypertrophy Adjacent organ tumors CancerColon cancerCervical cancerUterine cancer Any cancer that metastasizes (spreads) Idiopathic hydronephrosis of pregnancy
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.