Obstructive uropathy is a condition when the urine cannot flow (either partially or completely) through the ureter due to some type of obstruction. Instead of flowing from the kidneys to the bladder, the urine flows backward, or refluxes, into the kidneys.
A ureter is one of the tubes that carry urine between your kidney and your bladder. Obstructive uropathy can cause swelling and other damage to one or both of your kidneys. This condition can affect men and women of any age. It can also be a problem for an unborn child during pregnancy.
Causes of Obstructive Uropathy
Compression can lead to damage to your kidneys and the ureters that carry urine to the bladder. Temporary or permanent blockages in your ureter can result from:
Injuries such as a pelvic fracture
Tumor mass that spreads to the kidneys, bladder, uterus, or colon diseases of the digestive tract
Kidney stones trapped in the ureter
Blood clots
Nervous system disorders
Use of neurogenic drugs to control an overactive bladder
An enlarged prostate in men.
Additional weight of the fetus pressing down on the bladder in pregnant women. Although, pregnancy-induced uropathy is very rare.
Symptoms of Obstructive Uropathy
Sharp, quick and acute, or slow and progressive pain in midsection on one or both sides of the body. The level and location of pain however, varies from person-to-person and depends on whether one or both kidneys are involved.
Fever, nausea, and vomiting.
Swelling or tenderness in the kidneys as the urine flows backward into the organs.
Difficulty passing urine
Frequent urge to urinate, especially at night (nocturia)
The feeling that the bladder is not empty
Decreased urine output
Blood in the urine
Symptoms in Unborn Children
Abnormal low level of amniotic fluids in the womb. Urine is one of the components of amniotic fluid. A fetus with obstructive uropathy is unable to urinate outside their body. This leads to a drop in amniotic fluid volume, which can lead to fetal or birthing complications.
Diagnosis
It can be through:
Ultrasound: scans of the pelvic region and the kidneys will show if urine is backing up into your kidneys.
Imaging tools can also point out blockages to the doctor.
Treatment
The removal of the obstruction from the blocked ureters is the main goal of treatment which can be through any of the following:
Surgery: removal of masses such as cancerous tumors, polyps, or scar tissue that forms in and around the ureters. Once they clear the blockage from the affected ureter, urine can flow freely into the bladder.
Stent Placement: a less intrusive form of treatment is the placement of a stent in the blocked ureter or kidney. A stent is a mesh tube that opens up inside the ureter or blocked area of the kidney. Stenting can be a solution for ureters that become narrower from scar tissue or other causes. Your doctor will place a stent in the ureter with a flexible tube called a catheter. Catheterization is typically performed with the use of numbing medication while you’re awake. In some cases, you may be sedated for the procedure.
Treatment for Unborn Children
The doctor may be able to treat fetal obstruction in the womb in some cases. The doctor may place a shunt, or drainage system, in your unborn baby’s bladder. The shunt will drain urine into the amniotic sac. Fetal treatment is usually performed only when the baby’s kidneys appear to be irreversibly damaged. Most often, doctors can repair kidney function and blocked ureters after the baby is born.
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