Obstructive uropathy, or urinary tract obstruction, is a condition where your urine is unable to flow through your bladder, urethra, or ureter due to a partial or complete urinary tract blockage.
As a result, your urine flows backward into your kidneys rather than comfortably flowing from your kidneys to your bladder. This can lead to swelling and other damage to one or both of the kidneys.
Obstructive uropathy can affect women and men at any age. That being said, as you age, obstructive uropathy becomes more common, and is most often a side effect of benign prostatic hyperplasia or neurogenic bladder.
It is particularly significant in elderly men with benign prostatic hyperplasia (BPH)—also called an enlarged prostate.
It is also a common problem in unborn children during pregnancy, mainly due to birth defects that affect the urinary tract.
This article will catalog everything you need to know about obstructive uropathy. It will explain in detail how obstructive uropathy causes kidney damage, and also cover urinary tract obstruction causes, symptoms, complications, diagnosis, and how to treat urinary blockage.
Obstructive Uropathy Can Cause Kidney Damage
An obstruction along the urinary tract can increase pressure and slow urine flow. Urinary tract obstruction can be sudden or slow to develop over a number of days, weeks, or months. During this process, damage may be done to one or both of your kidneys.
Most of the time, urine flows from your kidneys at a very low pressure. If there is an obstruction, urine backs up and creates urinary blockage.
The urine later reaches the small tubes of the kidney and the holding area called the renal pelvis. This leads to the kidney to swell up, which increases pressure on its inside structures.
The increased pressure due to the urinary tract obstruction may lead to kidney damage and loss of kidney function. Urine flow obstruction can then lead to kidney stones, as well as a kidney infection due to bacteria in the urinary tract not being flushed out.
Kidney failure may also result when both kidneys are obstructed.
Over time, renal pelvis and ureter distention can also thwart the rhythmic muscular contractions that normally move urine from the kidney down through the ureter and into the bladder.
Permanent damage may then result when scar tissue replaces the normal muscular tissue of the ureter walls.
What Causes Obstructive Uropathy?
What are the most common obstructive uropathy causes? Obstructive uropathy can happen for a variety of reasons that depend on a person’s age and gender.
For instance, an enlarged prostate or prostate cancer is most common in older men. Older adults in general are more prone to tumors and stones.
In young women and men, the most common cause is kidney stones. In children, urinary tract obstruction is often due to birth defects of the posterior urethral valves and other constrictions that block the urethra or ureter.
Hydronephrosis is problem that often affects both kidneys during pregnancy, when the enlarged uterus compresses the ureters. Hormonal changes during pregnancy may also worsen the condition.
Hydroneophrosis often is resolved after pregnancy; however, the ureters and renal pelvis may remain somewhat distended.
Temporary or permanent urinary tract blockage can also result from blood clots or polyps in the ureter; kidney stones trapped in the ureter; digestive tract diseases; injuries like pelvic fractures; and tumors that spread to the bladder, uterus, kidneys, cervix, or colon.
Nervous system disorders can also cause urinary tract obstruction when the nerves responsible for bladder control fail to properly function. In some cases, neurogenic drugs used to control an overactive bladder can also cause urinary tract obstruction.
What Are the Symptoms of Urinary Tract Obstruction?
What are the symptoms of obstructive uropathy? The symptoms of the condition depend on whether the problem is sudden or starts slowly, or if one or both kidneys are involved.
Pain is the most common obstructive uropathy symptom. The pain can be minimal or completely absent with partial obstructive uropathy. With complete urinary tract obstruction, there may be severe pain that leads to nausea and vomiting.
Other symptoms may include fever, weight gain or swelling, and mild to severe pain in the back or on one or both sides of the body. Tenderness or swelling in the kidneys may also arise as urine flows back into the other organs.
When there is a blockage in the ureters, you may experience a change in urinary habits, including difficulty urinating, reduced amounts of urine, a slow dribbling of urine, a feeling that the bladder isn’t totally empty, blood in the urine, and a frequent urge to urinate—especially at night.
You may also experience reduced amounts of urine if one of your kidneys is blocked, though most of the time, both kidneys must be blocked to affect the output of urine.
Possible Complications of Obstructive Uropathy
What are possible obstructive uropathy complications? Urinary tract obstruction can lead to severe and permanent damage to the kidneys and kidney failure. Pyelonephritis, an infection of one or both kidneys, is common.
Long-term bladder damage may also result when obstructive uropathy is caused by bladder blockage. This is what leads to urine leakage and problems emptying the bladder.
A higher likelihood of recurrent urinary tract infections (UTIs) or cystitis is also common with obstructive uropathy, as well as acute or chronic renal failure and new-onset or poorly controlled hypertension.
People with UTIs may have blood or pus in their urine, fever, and kidney or bladder pain.
Diagnosis of Obstructive Uropathy
How is obstructive uropathy diagnosed? Your doctor will first obtain a full history of your symptoms, which often includes questions about kidney pain, reduced urine flow, and how often you urinate.
Typically, additional diagnostic tests are necessary to help doctors better understand the location of the urinary tract obstruction.
Bloodwork and urinalysis may first be given to observe potential signs of obstructive uropathy. Immediate action may be necessary if unusual levels of creatinine, urea nitrogen, or both are present when the obstruction has blocked both kidneys for several hours.
Results from urinalysis are often normal, unless red blood cells and white blood cells are present to indicate an infection, tumor, or stones as the cause of obstructive uropathy.
A bladder catheterization is often considered when there is diminished urine output or a distended bladder. This test will help restore normal urine flow. It can also determine urethral obstruction, which would make it difficult to bring the catheter up to the bladder.
Imaging tests can also be done to reveal urinary tract obstruction, such as the location of the blockage or hydronephrosis. For instance, ultrasonography is useful in pregnant women and children due to its accuracy and because it doesn’t expose anyone to radiation.
Voiding cystourethrography (VCUG) is another imaging test that can visualize bladder and urethra obstruction with an X-ray after a radiocontrast dye is inserted through a catheter and into the bladder.
Other tests used in the diagnosis of a urinary tract obstruction include a helical computed tomography (CT) scan, MRI (magnetic resonance imaging), invasive pyelography, intravenous pyelography (IVP), or a renal nuclear scan.
Treatment for Urinary Tract Obstruction
What is the most typical urinary tract obstruction treatment? The main goal of an obstructive uropathy treatment is to remove the obstruction from the blocked ureters.
Here are a few of the ways in which this is done:
- Surgery: Although short-term relief from the urinary blockage is possible without surgery, the cause of the blockage must be removed and repair of the urinary tract is needed. Long-term relief may require surgery. The kidney may be removed if blockages cause severe loss of kidney function. Surgeons may also need to remove scar tissue, polyps, or tumors that form around the ureters. Urine can flow freely into the bladder once the urinary blockage has been removed.
- Stent placement: Stent placement in the blocked kidney or ureter is a less intrusive treatment method. It is a mesh tube that opens up inside the blocked area. This may provide short-term symptom relief.
- Nephrostomy tubes: These tubes drain urine from the kidneys, and they may help bypass the urinary blockage.
- Foley catheter: When placed through the urethra into the bladder, a Foley catheter may also help with the flow of urine.
- Treatment for unborn children: In some cases, fetal obstruction in the womb may be treated with a shunt or drainage system in the unborn baby’s bladder. The shunt allows urine to drain into the amniotic sac. This type of treatment is used only when the baby’s kidneys suffer from irreversible damage. Most of the time, kidney function and blocked ureters can be repaired after the baby is born.
Obstructive uropathy treatment will also depend on the cause of obstruction. From a natural perspective, saw palmetto, pumpkin seed oil, nettle root, rye pollen extract, and beta-sitosterol are frequently named remedies that may reduce the symptoms of obstructive uropathy caused by an enlarged prostate.
Cranberry extract and uva ursi are herbal remedies used in the treatment of obstructive uropathy caused by kidney stones or bladder infections.
Final Thoughts on Obstructive Uropathy
The good news is that most urinary tract obstruction causes can be corrected. However, obstructive uropathy treatment is necessary immediately when symptoms are present, or there may be irreversible kidney damage.
Kidney damage is less likely when urinary tract obstruction is diagnosed and treated quickly, but if there is a severe obstruction that damages both kidneys, a kidney transplant or dialysis may be needed.
If you suffer from urinary tract obstruction, consult your doctor or natural practitioner to help determine the cause and most appropriate treatment. Depending on the cause, natural methods may be able to treat symptoms related to the obstruction.
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