Urinary tract obstruction is a urologic disease consisting of a decrease in the free passage of

urine Urine is a liquid by-product of metabolism in humans and many other animals. In placental mammals, urine flows from the Kidney (vertebrates), kidneys through the ureters to the urinary bladder and exits the urethra through the penile meatus (mal ...

through one or both

ureter The ureters are tubes composed of smooth muscle that transport urine from the kidneys to the urinary bladder. In an adult human, the ureters typically measure 20 to 30 centimeters in length and about 3 to 4 millimeters in diameter. They are lin ...

s and/or the

urethra The urethra (: urethras or urethrae) is the tube that connects the urinary bladder to the urinary meatus, through which Placentalia, placental mammals Urination, urinate and Ejaculation, ejaculate. The external urethral sphincter is a striated ...

. It is a cause of

urinary retention Urinary retention is an inability to completely empty the bladder. Onset can be sudden or gradual. When of sudden onset, symptoms include an inability to urinate and lower abdominal pain. When of gradual onset, symptoms may include urinary incont ...

. Complete obstruction of the urinary tract requires prompt treatment for renal preservation.Chowdhury SH, Cozma AI, Chowdhury JH. Urinary Tract Obstruction. Essentials for the Canadian Medical Licensing Exam: Review and Prep for MCCQE Part I. 2nd edition. Wolters Kluwer. Hong Kong. 2017. Any sign of infection, such as fever and chills, in the context of obstruction to urine flow constitutes a urologic emergency.

Causes

Causes of urinary tract obstruction include: *

Bladder stone A bladder stone is a stone found in the urinary bladder. Signs and symptoms Bladder stones are small mineral deposits that can form in the bladder. In most cases bladder stones develop when the urine becomes very concentrated or when one is ...

and renal stone *

Benign prostatic hyperplasia Benign prostatic hyperplasia (BPH), also called prostate enlargement, is a noncancerous increase in size of the prostate gland. Symptoms may include frequent urination, trouble starting to urinate, weak stream, urinary retention, inability t ...

* Obstruction as a

congenital disorder A birth defect is an abnormal condition that is present at childbirth, birth, regardless of its cause. Birth defects may result in disability, disabilities that may be physical disability, physical, intellectual disability, intellectual, or dev ...

. * Foreign object such as a bullet or pellet.

Congenital urinary tract obstruction

Urinary tract obstruction as a

results in

oligohydramnios Oligohydramnios is a medical condition in pregnancy characterized by a deficiency of amniotic fluid, the fluid that surrounds the fetus in the abdomen, in the amniotic sac. The limiting case is anhydramnios, where there is a complete absence of ...

which in turn can lead to the Potter sequence of atypical physical appearance. Pulmonary hypoplasia is by far the main cause of death in the early neonatal period for children with congenital lower urinary tract obstruction. Fetal surgery of congenital lower urinary tract obstruction seems to improve survival, according to a randomized yet small study. Urinary tract obstruction due to foreign object While uncommon, there are case reports in the human and veterinary literature of a bullet or other ballistic projectile migrating to the urethra and causing a urinary tract obstruction. This has been reported in people, small animals, and a goat.

Sitting voiding position

meta-analysis Meta-analysis is a method of synthesis of quantitative data from multiple independent studies addressing a common research question. An important part of this method involves computing a combined effect size across all of the studies. As such, th ...

on the influence of voiding position on urodynamics in healthy males and males with LUTS showed that in the sitting position, the residual urine in the bladder was significantly reduced. The other parameters, namely the maximum urinary flow and the voiding time were increased and decreased respectively. For healthy males, no influence was found on these parameters, meaning that they can urinate in either position.

Diagnosis

Diagnosing urinary tract obstruction involves several steps and tests to determine the location and severity of the blockage. Here are some common methods used: Medical History and Physical Examination: The doctor will ask about symptoms, medical history, and perform a physical examination to check for signs of urinary tract obstruction. Imaging Tests: * Ultrasound: This is often the first imaging test used to detect obstructions in the urinary tract. * CT Scan: Provides detailed images of the urinary tract and can help identify the location and cause of the obstruction. * MRI: Used in some cases to get detailed images of the urinary tract. Urine Tests: These tests can detect signs of infection, blood, or other abnormalities in the urine. Blood Tests: These tests can check for signs of kidney damage or infection. Cystoscopy: A procedure where a thin tube with a camera is inserted into the urethra to examine the bladder and urethra for obstructions. Urodynamic Tests: These tests measure the pressure and flow of urine to help identify blockages. Nuclear Scans: These scans use a small amount of radioactive material to evaluate kidney function and detect obstructions.

Treatment

Treatment depends on the underlying cause of the obstruction and the severity of the symptoms.

References

External links

{{Medical resources , ICD10 = , ICD9 = , ICDO = , OMIM = , DiseasesDB = , MedlinePlus = , eMedicineSubj = article , eMedicineTopic = 438890 , MeSH = , GeneReviewsNBK = , GeneReviewsName = Urological conditions