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Alternative names Return to top
Obstructive uropathy - unilateral - acute; Ureteral obstructionDefinition Return to top
Urine is drained from the kidneys through tubes called ureters. Obstructive uropathy occurs when a one or both ureters becomes blocked; the condition may be acute or chronic.
Acute unilateral obstructive uropathy involves a sudden blockage of one ureter, resulting in a backup of urine and injury to the kidney.
Causes, incidence, and risk factors Return to top
Unilateral obstructive uropathy occurs when urine cannot drain through a ureter because of an obstruction. Urine backs up into the kidney and causes distention of the renal pelvis and calyces (hydronephrosis).
The blockage is most often caused by a kidney stone, although injury or other conditions could cause the disorder.
Risks for unilateral obstructive uropathy include ureteral stones and tumors, kidney stones, and tumors in surrounding structures such as the uterine cervix.
The disorder may result in permanent damage to the kidney and may be a cause of hypertension. It usually does not cause kidney failure because the second kidney continues to function.
Acute unilateral obstructive uropathy occurs in 1 in 1,000 people.
Symptoms Return to top
Signs and tests Return to top
A history of acute ureteric colic may indicate unilateral obstructive uropathy. Palpation of the abdomen reveals an enlarged or tender kidney. Blood pressure may or may not be elevated. Fever may or may not be present (infection).
The following tests may be conducted:
Hydronephrosis and/or obstruction of the ureter may appear on these tests:
Treatment Return to top
Treatment focuses on eliminating or minimizing the obstruction.
Antibiotics may be given if there is a urinary tract infection.
Stents or drains placed in the ureter or in the renal pelvis may provide short-term relief of symptoms. Surgery to repair the underlying cause of the obstruction will usually eliminate the problem.
Nephrectomy (removal of the kidney) or nephrotomy (incision into the kidney) may be required if the kidney functions poorly or is severely infected.
Expectations (prognosis) Return to top
The outcome varies. Kidney damage may be permanent. However, if the cause of the obstruction is diagnosed and treated early, the damage may be temporary. If only one kidney is involved, the other kidney usually continues to function adequately and renal insufficiency or renal failure does not occur.Complications Return to top
Calling your health care provider Return to top
Call your health care provider if flank pain or other symptoms of acute unilateral obstructive uropathy develop.
Call your health care provider if symptoms worsen during or after treatment, or if new symptoms develop.
Prevention Return to top
If you are prone to kidney stones, drink plenty of water (6 to 8 glasses per day) to reduce the chances of their formation.
Research suggests that a diet low in sodium and oxalate and high in citrate significantly reduces risk of calcium-based kidney stone formation. Consult with a nutritionist for more information on such diets.
Seek medical attention if kidney stones persist or recur to identify the cause and to prevent new stones from forming.
Update Date: 5/25/2002 Updated by: Young Kang, M.D., Department of Urology, Columbia University College of Physicians and Surgeons, New York, NY. Review provided by VeriMed Healthcare Network.
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Page last updated: 28 October 2004 |