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Obstructive Uropathy

Overview

A disorder involving sudden blockage of the flow of urine out of the bladder and urethra, which may result in the backup of urine and injury to both kidneys.


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Causes

Obstructive uropathy occurs when the flow of urine is blocked. The kidneys produce urine in the normal manner but the urinedoes not drain properly because of an obstruction. Pressure in the urinary tract rises, resulting in hydronephrosis (distention ofthe kidney pelvis and calyces) and bilateral obstructive uropathy (damage to both kidneys caused by obstruction of urine).Obstructive uropathy can eventually lead to hypertension and/or acute renal failure . Sudden blockage causes acute bilateralobstructive uropathy, while slow progressive blockage causes chronic bilateral obstructive uropathy .Acute bilateral obstructive uropathy is caused by obstruction of the urethra that occurs suddenly or over a short time. In men, itis most often a result of an enlarged prostate. It is much less common in women but can occur as a result of bladder cystocele .Other causes include bladder tumors, tumors of the prostate, and tumors or other structures around thebladder neck or urethra, especially if the tumors grow quickly and by strictures in any part of the genito-urinary tract. A historyof kidney stones or bladder stones increases the risk of acute bilateral obstructive uropathy.Initially, the bladder reacts to the obstruction through increased irritability. There is a stronger and more frequent urge tourinate, and bladder spasms or incontinence may occur. As urine accumulates, it may lead to stasis of urine and urinary tractinfections (see UTI - acute) . Urine may back up into the ureters and kidney. Symptoms develop because of urinary retentionand/or damage to the bladder, ureters, and kidneys from backup (reflux) of urine.Acute bilateral obstructive uropathy occurs in about 5 out of 10,000 people.


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Signs & Symptoms

decreased urine output (may be less than 10 ml per day)- urinary hesitancy- abnormal urine flow--dribbling at the end of urination- incontinence- decrease in the force of the urinary stream, stream small and weak- urinary frequency/urgency, increased- need to urinate at night- frequent strong urge to urinate- burning or stinging with urination- feeling of incomplete emptying of the bladder- flank pain or pain in the sides- on both sides- began suddenly- blood in the urine- high blood pressure (hypertension) , recent increase- urine, abnormal color.

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Prevention

This disorder may not be preventable in many cases. Routine rectal examination for men may reveal an enlarged prostate beforeit becomes large enough to obstruct the urethra.


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Treatments
Short term treatment Modern Medicine

Aim of treatment includes

  • Treatment to relieve blockage
  • Antibiotics to relieve the symptoms
  • Catheterization is done for drainage of urine 
Surgery Modern Medicine

Long term treatment includes surgery or laser therapy if problem is because of enlarged prostate

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