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Chronic bilateral obstructive uropathy is a long-term blockage of urine flow from both kidneys. It is a slow blockage that gets worse over time.
Bilateral means "both sides."
See also:
- Chronic unilateral obstructive uropathy
- Acute unilateral obstructive uropathy
- Acute bilateral obstructive uropathy
Obstructive uropathy - bilateral - chronic; Kidney failure - chronic blockage
Causes, incidence, and risk factorsThe most common cause of chronic bilateral obstructive uropathy is a condition called bladder outlet obstruction. The kidneys produce urine in the normal manner but the urine cannot leave the bladder. Urine backs up, causing kidney swelling and damage.
When the blockage causes urine to back up into both kidneys, hydronephrosis(swelling of the kidneys) results. High blood pressure and kidney failure can result.
In men, chronic bilateral obstructive uropathy is most often a result a result of enlargement of the prostate, also called benign prostatic hyperplasia (BPH).
Other causes of chronic bilateral obstructive uropathy include:
- Bilateral uretal stones
- Bladder tumors
- Prostate tumors
- Tumors or masses of the uterus or other structures around the bladder neck or urethra
- Retroperitoneal fibrosis or tumor
- Narrowing of the urethra due to a birth defect or scar tissue
- Neurogenic bladder
Chronic bilateral obstructive uropathy occurs in about 1 out of every 1,000 people.
SymptomsSymptoms depend on the nature of the obstruction and where in the urinary tract the obstruction occurs.
Some of the most common symptoms of chronic obstructive uropathy include:
- Stronger and more frequent urge to urinate
- Difficulty initiating the flow of urine (urinary hesitancy)
- Dribbling of urine, incontinence
- Decreased urine output
- Decrease in the force of the urinary stream
- Increased need to urinate at night
- Burning or stinging with urination
- Feeling of incomplete emptying of the bladder
- Alternating times of increased urine output and decreased urine output
- Fever and chills (if there is also a urinary tract infection)
Additional symptoms that may be associated with this disease:
- Nail problems
- High blood pressure
- Abnormal urine color
A physical exam may show swollen or tender kidneys. The bladder may be large and full. A rectal examination may reveal an enlarged prostate. Blood pressure may be high.
Blood tests will be done to check kidney function, electrolyte balance, and blood cell counts. Urine tests may reveal a urinary tract infection.
Other tests that may be done:
- Abdominal ultrasound
- Bladder scan
- CT scan of abdomen and pelvis
- Kidney scan
- Uroflowmetry
The goal of treatment is to remove the blockage. You may need to stay in a hospital for a short while.
Treatment may include:
- Antibiotics to treat urinary tract infection
- Catheterization-- the placement of a tube into the body to drain urine (See: Urinary catheters)
- Dialysis if kidney failure occurs
- Laser or heat therapy to shrink the prostate if the problem is due to an enlarged prostate
- Surgery such as transurethral resection of the prostate (TURP)
- Other types of surgery for disorders causing blockage of the urethra or bladder neck
Bilateral obstructive uropathy may be reversible if the blockage is corrected before kidney failure develops.
Chronic kidney failure leads to long-term kidney damage that can be life threatening.
Patients with a chronic blockage are at a higher risk for complications following initial catheter placement. During the first few days following correction of the obstruction, the kidneys may be unable to concentrate urine. As a result, your body removes large amounts of urine that haven't been properly processed. This is called post-obstructive diuresis. It can be a life-threatening condition. Close monitoring is required.
If the obstruction was caused by cancer, the ultimate outcome depends on the disease severity and your response to treatment.
Complications- Chronic kidney failure
- Complications due to long-term catheter use
- Chronic or recurrent urinary tract infection
- Long-term incontinence or urinary retention
- Formation of uretal or kidney stones
Call your health care provider if decreased urine output or other symptoms of chronic bilateral obstructive uropathy develop.
PreventionRoutine screening (and treatment) for lower urinary tract disorders may help prevent this condition. A digital rectal exam is used to screen men for prostate problems.
ReferencesPais VM Jr, Strandhoy JW, Assimos DG. Pathophysiology of urinary tract obstruction. In: Wein AJ, ed. Campbell-Walsh Urology. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 37.
Hsu THS, Streem SB, Nakada SY. Management of upper urinary tract obstruction. In: Wein AJ, ed. Campbell-Walsh Urology. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 38.
McAninch JW, Santucci RA. Renal and ureteral trauma. In: Wein AJ, ed. Campbell-Walsh Urology. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 39.
What else can I help you with?
Obstructive uropathy?
DefinitionObstructive uropathy is a condition in which the flow of urine is blocked, causing it to back up and injure one or both kidneys.Alternative NamesUropathy - obstructiveCauses, incidence, and risk factorsObstructive uropathy occurs when urine cannot drain through a ureter (a tube that carries urine from the kidneys to the bladder). Urine backs up into the kidney and causes it to become swollen (hydronephrosis).Obstructive uropathy is grouped according to whether it affects one or both kidneys and whether it occurs suddenly or is long-term:Chronic unilateral obstructive uropathy - Long-term uropathy that affects one kidneyChronic bilateral obstructive uropathy - Long-term uropathy that affects both kidneysAcute unilateral obstructive uropathy - Sudden uropathy that affects one kidneyAcute bilateral obstructive uropathy -Sudden uropathy that affects both kidneysCommon causes of obstructive uropathy include the following:Urinary tract stonesUreteral stonesBladder stonesUrinary tract tumorsRetroperitoneal fibrosisBenign prostatic hyperplasia (enlarged prostate)Tumors of nearby organsBladder or ureteral cancerColon cancerCervical cancerUterine cancerAny cancer that spreadsIdiopathic hydronephrosis of pregnancySymptomsSymptoms associated with obstructive uropathy vary depending on whether the obstruction is acute or chronic, whether it is unilateral or bilateral, whether it is complete or partial, and what caused it. Common symptoms of obstructive uropathy include the following:Flank painBilateral or unilateralColicky or severeUrinary tract infectionFeverDifficulty or pain while urinatingNausea or vomitingRenal failureWeight gain or swelling (edema)Decreased urine outputBlood in the urineSigns and testsThe diagnosis of obstructive uropathy is made on imaging studies. Common radiographic studies used to diagnose obstructive uropathy include:Abdominal ultrasoundAbdominal CT scanIntravenous pyelogram (IVP)Voiding cystourethrogramRenal nuclear scanTreatmentStents or drains placed in the ureter or in the renal pelvis may provide short-term relief of symptoms. Nephrostomy tubes, which drain urine from the kidneys through the back, may be used to bypass the obstruction. A Foley catheter, inserted through the urethra, may also be helpful.Although temporary relief from the obstruction can be achieved without surgery, the cause of the obstruction must be removed and the urinary system repaired. Long-term relief from obstructive uropathy requires surgery.Expectations (prognosis)If an acute obstruction is rapidly diagnosed and repaired, kidney damage is minimal or reversible -- regardless of being unilateral or bilateral.If chronic unilateral obstruction is not relieved promptly there could be permanent damage to the kidney. Chronic unilateral obstruction usually does not cause kidney insufficiency or failure because most patients have normal function from the other kidney.Chronic bilateral obstruction may lead to kidney insufficiency or failure because both kidneys may become damaged and fail to function even after the obstruction is repaired.For more specific information, see the individual articles below:Chronic unilateral obstructive uropathyChronic bilateral obstructive uropathyAcute unilateral obstructive uropathyAcute bilateral obstructive uropathyComplicationsObstructive uropathy can cause permanent and severe damage to the kidneys, resulting in renal failure. Obstructive uropathy caused by bladder outlet obstruction can lead to permanent and severe damage to the bladder, resulting in problems such as incontinence and urinary retention.Calling your health care providerContact your health care provider if you have symptoms of obstructive uropathy or believe that you may be suffering from this condition.PreventionObstructive uropathy can be prevented by addressing any underlying disorders that can cause it.ReferencesPais VM Jr, Strandhoy JW, Assimos DG. Pathophysiology of urinary tract obstruction. In: Wein AJ, ed. Campbell-Walsh Urology. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 37.Hsu THS, Streem SB, Nakada SY. Management of upper urinary tract obstruction. In: Wein AJ, ed. Campbell-Walsh Urology. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 38.McAninch JW, Santucci RA. Renal and ureteral trauma. In: Wein AJ, ed. Campbell-Walsh Urology. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 39.Frokiaer J, Zeidel ML. Urinary tract obstruction. In: Brenner BM, ed. Brenner and Rector's The Kidney. 8th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 35.
What is Chronic obstructive lung disease also known as?
Chronic obstructive pulmonary disease (COPD) is also known as chronic obstructive lung disease (COLD), chronic obstructive airway disease (COAD),chronic airflow limitation (CAL) and chronic obstructive respiratory disease (CORD).
What is the scientific name for chronic obstructive pulmonary disease?
The scientific name for chronic obstructive pulmonary disease is COPD.
What does the medical abbreviation COAD mean?
Chronic Obstructive Airways DiseaseChronic Obstructive Airways Disease
Is COPD is a disease that is a combination of lung cancer and bronchitis?
Chronic Obstructive Pulmonary Disease (COPD)
Does class affect Chronic obstructive lung disease?
Chronic obstructive lung disease deaths are about twice as high among unskilled and semi-skilled laborers as among professionals
Is there any information on a copd?
COPD is an acronym for the disease called Chronic obstructive pulmonary disease. Chronic obstructive pulmonary disease is a lung disease that, unfortunately, at the moment, has no cure.
What is chronic obstructive pulmonary disease also called?
COPD
Does chronic obstructive pulmonary disease qualify for V.A. disability?
no
Does Leonard nimoy have emphysema?
He had Chronic Obstructive Pulmonary Disease.
Chronic obstructive pulmonary disease is also know as what?
Emphysema
What are the symptoms of chronic obstructive pulmonary disease?
If you start to notice constant coughing, shortness of breath, and wheezing, it may be chronic obstructive pulmonary disease. This cough is likely to not be a dry cough.
