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Urinary Tract Obstruction

The basic function of the kidney is the formation of an ultra-filtrate. Once this occurs, the remaining portions of the urinary tract function is to eliminate urine. When there is a structural impedance to the flow of urine anywhere along that tract, it is described as obstructive uropathy. Obstruction with subsequent hydronephrosis is a common clinical occurrence.

Urinary tract obstruction can result in a wide range of symptoms from asymptomatic to severe renal colic and renal failure. The symptoms depend upon:

  • Duration over which the obstruction occurs.
  • Unilateral or bilateral obstruction.
  • Complete or partial obstruction.
  • Etiology of obstruction.

Causes of obstruction

  • Meatal stenosis
  • Urethral strictures
  • Posterior urethral valves
  • Ectopic ureters
  • Ureteroceles
  • Ureterovesical obstruction
  • Ureteropelvic junction obstruction
  • Spina bifida/Myelo meningiocele
  • Vesicoureteral re-flux
  • BPH
  • Prostate cancer
  • Bladder cancer
  • Ureteral stone
  • Retroperitoneal fibrosis
  • Extrinsic obstruction of ureter
  • Neurogenic bladder

Diagnosis

  • Excretory urography
  • Ultrasonography
  • Renal flow scan
  • Diuretic renal flow scan
  • CT scan