Obstructive uropathy is a urological condition in which urine flow is obstructed in some way, causing a buildup of urine that can harm the kidneys. This can be caused by a number of different diseases and can occur unilaterally or bilaterally, so one or both kidneys are affected. It can be either chronic or sudden and can occur at any age. Obstructive uropathy can lead to serious kidney damage, called obstructive nephropathy, if not treated right away, but if caught soon enough there should be no lasting damage.
There are several possible causes of obstructive uropathy. The first is anatomical abnormalities in which some component of the urinary tract is malformed or not fully functional, which is particularly likely to be the cause of this condition in infants. Obstruction can also be a side effect of some other condition, such as compression of the urinary tract due to pregnancy or a tumor in the surrounding tissues. A physical blockage, such as a kidney stone or blood clot, may also partially or completely obstruct the urinary tract.
Early diagnosis of obstructive uropathy is important for a positive outcome. The most obvious symptom of obstructive uropathy is problems with urination, including reduced urine output, difficulty or pain when urinating, urinary tract infection, or blood in the urine. There might be no urine-related symptoms if the blockage is only on one side, however, so normal urination does not necessarily mean the patient does not have obstructive uropathy. Other symptoms include pain in the flank and pelvic area, fever, nausea, weight gain, and swelling.
Obstructive uropathy is usually definitively diagnosed using imaging tests, such as an abdominal ultrasound or CT scan. This also reveals the location of the obstruction and helps to discover what could be causing it. Urine tests are also performed to diagnose infection or any other chemical abnormalities. This is particularly important if the patient has symptoms of a urinary tract infection since the combination of infection and obstruction can be more dangerous than obstruction or infection alone.
Treatment involves first relieving the back-up of urine using a catheter inserted through the urethra or directly into the bladder or kidneys. This only stops the symptoms, and then the reason for the obstruction must be discovered and addressed. The variety of reasons for obstruction means that the treatment will vary widely for different patients, and might be a minor procedure or require major surgery. It is also possible that urinary tract problems could be the first symptom that leads to the diagnosis of cancer or other serious condition. If the urinary tract has been damaged, surgery may be required to repair it.
