Obstructive uropathy is a structural or functional hindrance of normal
urine flow, sometimes leading to renal dysfunction (obstructive
nephropathy).
It is a very broad term, and does not imply a location or cause.
Presentation
Symptoms, less likely in chronic obstruction, are pain radiating to the T11 to T12
dermatomes,
anuria,
nocturia, or
polyuria.
Causes
It can be caused by a lesion at any point in the
urinary tract.
Causes include
urolithiasis,
[ ] posterior urethral valves and ureteral herniation.
Diagnosis
Diagnosis is based on results of bladder
catheterization
In medicine, a catheter (/ˈkæθətər/) is a thin tube made from medical grade materials serving a broad range of functions. Catheters are medical devices that can be inserted in the body to treat diseases or perform a surgical procedure. Cath ...
,
ultrasonography,
CT scan
A computed tomography scan (CT scan; formerly called computed axial tomography scan or CAT scan) is a medical imaging technique used to obtain detailed internal images of the body. The personnel that perform CT scans are called radiographers ...
,
cystourethroscopy
Cystoscopy is endoscopy of the urinary bladder via the urethra. It is carried out with a cystoscope.
The urethra is the tube that carries urine from the bladder to the outside of the body.
The cystoscope has lenses like a telescope or microscope ...
, or
pyelography
Pyelogram (or pyelography or urography) is a form of imaging of the renal pelvis and ureter.
Types include:
* Intravenous pyelogram – In which a contrast solution is introduced through a vein into the circulatory system.
* Retrograde pyelogram ...
, depending on the level of obstruction.
Treatment
Treatment, depending on cause, may require prompt drainage of the
bladder via
catheterization
In medicine, a catheter (/ˈkæθətər/) is a thin tube made from medical grade materials serving a broad range of functions. Catheters are medical devices that can be inserted in the body to treat diseases or perform a surgical procedure. Cath ...
, medical instrumentation, surgery (e.g.,
endoscopy,
lithotripsy),
hormonal therapy, or a combination of these modalities.
Treatment of the obstruction at the level of the ureter:
:* Open surgery.
:* Less invasive treatment: laparoscopic correction.
:* Minimal invasive treatment: Overtoom procedure: dilatation with cutting
balloon catheter followed by introduction of the
pyeloplasty balloon catheter.
This balloon is inflated with pure contrast agent via the pusher and remains in situ in the ureter to keep the previous treated stricture dilated while the expanded
urothelium heals. Urine can drain through the central channel of this catheter.
References
External links
{{Urinary tract disease
Urological conditions