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Diagnosis / Blocked Urinary Tract

A blocked urinary tract, also known as obstructive uropathy, occurs when there is a blockage in the ureters, urethra or bladder that inhibits the flow of urine from the kidneys to the bladder. The blockage can be partial or complete, and may affect one or both sides. If left untreated, obstructive uropathy can cause kidney stones, infection, and kidney damage.

What is Obstructive Uropathy?

Obstructive uropathy is caused by a blockage anywhere along your urinary tract – from the kidneys (where urine is produced) through the ureters (the tubes that carry urine to the bladder) to the bladder and urethra (where urine is stored and released). A blockage in the urinary tract, whether partial or complete, can increase the pressure inside the affected areas and result in swelling or damage to your kidneys.

Depending on the severity of the issue, a blockage in your urinary tract inhibits or stops the flow of urine through the ureters, bladder or urethra. If the urine is prevented from moving forward in its usual path, it refluxes, flowing backward into your kidneys.

When your urinary tract is functioning normally, urine flows from the kidneys at a low pressure. If there is a blockage that causes the urine to reflux, it increases the pressure on the kidneys and causes them to swell. This is known as hydronephrosis. If left untreated, the constant increased pressure on the kidneys can damage them, causing a loss in function. Other issues associated with obstructive uropathy include the higher likelihood of developing kidney stones, as well as increased risk for a urinary tract infection because bacteria is not being flushed out. In cases where obstructive uropathy affects both kidneys, lack of treatment can ultimately result in renal failure.

Causes of Urinary Tract Obstruction

Obstructive uropathy may affect five out of every 1,000 people, and can be caused by several factors. The most common causes include:

  • Kidney stones
  • Polyps or blood clots in the ureter
  • Tumors in or near the ureter or organs located in the pelvis
  • Muscle or nerve disorders in the urinary tract system
  • Scar tissue from previous surgery
  • Prostate cancer
  • Benign prostatic hyperplasia (enlarged prostate)

Because benign prostatic hyperplasia is a condition that is common in older men, urinary tract obstruction is found to be more common among men than women.

Symptoms of a Blocked Urinary Tract

Symptoms of obstructive uropathy depend on the cause of the issue, location of the blockage, and how long it has been there. If the blockage is acute (happens suddenly) symptoms are usually more common. If the blockage is chronic (develops over time), symptoms may be intermittent or nonexistent. The level of pain and area where it occurs varies, and also depends on whether only one or both of the kidneys are affected. Some of the symptoms of a blocked urinary tract include:

  • Change in urinary habits – slowed stream, decreased output, feeling that your bladder isn’t empty, frequent urge to urinate, increased urination at night
  • Abdominal pain
  • Nausea or vomiting
  • Renal colic – distension of the kidney causes pain in the area between the ribs and hips on the affected side
  • Distension, pain or pressure in the bladder
  • Dull, aching pain in the lower back
  • Urinary tract infection

If you are experiencing any of these symptoms, it may be time for you to see a doctor to make sure that you are not suffering from a urinary tract blockage.

Diagnosing and Treating Obstructive Uropathy

It is important that you are diagnosed and treated as early as possible, to avoid potentially serious kidney damage. If your doctor suspects a blockage in your urinary tract, they may order one or more of the following tests:

  • Blood and urine tests – Blood and urine tests typically results are often normal, but can show certain signs of blockages. Blood tests may show increased levels of urea nitrogen or creatinine if both kidneys have been blocked. Urine tests can show if a stone is the root of the problem, or if there is an infection present.
  • Imaging scans – Ultrasounds are usually the most effective at identifying an obstruction, however, your doctor may also use a CT scan or MRI if necessary.
  • Bladder catheterization – If your symptoms point to bladder distension, your doctor may insert a catheter to determine if there is a backup of urine in the bladder. If a large amount of urine is drained, it means that either your bladder outlet or urethra are blocked.
  • Endoscopy – an endoscopy using either a cystoscope or a ureteroscope can be used to examine the kidneys, ureters, bladder, urethra and prostate to determine if there is an obstruction present.

The main goal when treating obstructive uropathy is to remove the obstruction from the affected area. Depending on the location and severity of the blockage, your doctor may opt for surgery to remove the obstruction or place a stent in the blocked kidney or ureter to open up the pathway. In some cases, medication may also be a viable option.

If you have been diagnosed with obstructive uropathy, call IVC today at 503-612-0498 to schedule an appointment with one of our team of experienced and professional interventional radiologists. You can also read our brochure on Kidneys and Dialysis.

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Jason Bauer, MD RVT
Michael Pfister, MD RVT

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