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Obstructive uropathy

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Anonymous

 ∙ 14y ago
Updated: 11/10/2020
Definition

Obstructive uropathy is a condition in which the flow of urine is blocked, causing it to back up and injure one or both kidneys.

Alternative Names

Uropathy - obstructive

Causes, incidence, and risk factors

Obstructive 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:

Common causes of obstructive uropathy include the following:

Symptoms

Symptoms 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:

Signs and tests

The diagnosis of obstructive uropathy is made on imaging studies. Common radiographic studies used to diagnose obstructive uropathy include:

Treatment

Stents 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:

Complications

Obstructive 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 provider

Contact your health care provider if you have symptoms of obstructive uropathy or believe that you may be suffering from this condition.

Prevention

Obstructive uropathy can be prevented by addressing any underlying disorders that can cause it.

References

Pais 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.

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 ∙ 14y ago

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Related Questions

Atropine is contraindicated in what conditions?

Atropine is contraindicated in conditions such as glaucoma, particularly narrow-angle glaucoma, where it can increase intraocular pressure. It is also contraindicated in patients with myasthenia gravis, as it can exacerbate muscle weakness. Additionally, atropine should be avoided in cases of obstructive uropathy or gastrointestinal obstruction, where its anticholinergic effects could worsen the situation.

Chronic bilateral obstructive uropathy?

DefinitionChronic 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 uropathyAcute unilateral obstructive uropathyAcute bilateral obstructive uropathyAlternative NamesObstructive uropathy - bilateral - chronic; Kidney failure - chronic blockageCauses, 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 stonesBladder tumorsProstate tumorsTumors or masses of the uterus or other structures around the bladder neck or urethraRetroperitoneal fibrosis or tumorNarrowing of the urethra due to a birth defect or scar tissueNeurogenic bladderChronic 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 urinateDifficulty initiating the flow of urine (urinary hesitancy)Dribbling of urine, incontinenceDecreased urine outputDecrease in the force of the urinary streamIncreased need to urinate at nightBurning or stinging with urinationFeeling of incomplete emptying of the bladderAlternating times of increased urine output and decreased urine outputFever and chills (if there is also a urinary tract infection)Additional symptoms that may be associated with this disease:Nail problemsHigh blood pressureAbnormal urine colorSigns and testsA 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 ultrasoundBladder scanCT scan of abdomen and pelvisKidney scanUroflowmetryTreatmentThe 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 infectionCatheterization-- the placement of a tube into the body to drain urine (See: Urinary catheters)Dialysis if kidney failure occursLaser or heat therapy to shrink the prostate if the problem is due to an enlarged prostateSurgery such as transurethral resection of the prostate (TURP)Other types of surgery for disorders causing blockage of the urethra or bladder neckExpectations (prognosis)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.ComplicationsChronic kidney failureComplications due to long-term catheter useChronic or recurrent urinary tract infectionLong-term incontinence or urinary retentionFormation of uretal or kidney stonesCalling your health care providerCall 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.

Can kidney stones cause epididymitis?

Kidney stones themselves do not directly cause epididymitis, which is typically due to infections or inflammation of the epididymis. However, if a kidney stone causes complications such as urinary tract infections or obstructive uropathy, it could indirectly lead to conditions that might result in epididymitis. Therefore, while there is no direct link, kidney stones can contribute to scenarios where epididymitis may occur.

Chronic unilateral obstructive uropathy?

DefinitionChronic unilateral obstructive uropathy is a condition in which there is long-term blockage of one of the tubes (ureters) that drains urine from the kidneys.See also:Acute unilateral obstructive uropathyAcute bilateral obstructive uropathyChronic bilateral obstructive uropathyObstructive uropathyAlternative NamesUreteral obstruction - chronic; Obstructive uropathy - unilateral - chronicCauses, incidence, and risk factorsUnilateral obstructive uropathy usually occurs when ureteral or kidney stones block the flow of urine. Urine backs up and causes kidney swelling (hydronephrosis).Other causes include:Narrowing of the ureter that is present at birth (congenital), most commonly right below the kidney, a condition called ureteropelvic junction obstructionInjury to the ureter from prior abdominal or pelvic surgeryRisk factors for unilateral obstructive uropathy include:Kidney stonesTumors in surrounding structures such as uterus, cervix, or lymph nodesUreteral stones and tumorsChronic unilateral obstructive uropathy occurs in approximately 5 out of every 1,000 people.SymptomsAbdominal pain, right or left lower belly areaBack pain, may be on only one sideBlood in the urineIncreased urinary frequency/urgencyFrequent need to urinate at nightPainful urinationSevere flank pain that may occur on one side, but may also be felt in the groin, thigh, and genitalsUrinary tract infectionSigns and testsYour health care provider will perform a physical exam, which includes feeling your abdomen. The exam may reveal a swollen kidney.A blood pressure measure may reveal high blood pressure. A urinalysis may show blood in the urine. A urine culture can determine if you have an infection.Kidney swelling or blockage of the ureter may appear on these tests:Abdominal ultrasoundIntravenous pyelogram (IVP)Kidney or abdominal CT scanTreatmentThe goal of treatment is to reduce or remove the blockage.Stents or drains placed in the ureter or in the renal pelvis may provide short-term relief of symptoms.A nephrostomy tube, which drains urine from the kidney through the back, may be used to relieve the blockage.Surgery to repair the underlying cause will usually correct the blockage.Expectations (prognosis)This condition damages the structures of the urinary tract. It may result in permanent damage to the kidney. If only one kidney is involved, the other kidney usually continues to work, and kidney failure or insufficiency does not occur.ComplicationsChronic or recurrent urinary tract infectionHigh blood pressurePermanent failure of the affected kidney (chronic kidney failure)Calling your health care providerCall your doctor if you have flank pain or other symptoms of chronic unilateral obstructive uropathy.If you have already been diagnosed with this condition, call your health care provider if symptoms worsen or persist despite treatment, or if new symptoms develop.PreventionIf you are prone to kidney stones, drink plenty of water (6 to 8 glasses per day) to reduce the chances of their formation.A diet low in sodium and oxalates and high in citrate may reduce your risk of calcium-based kidney stone formation. Talk to a nutritionist for more information on such diets.Urinary tract infections should be treated promptly and thoroughly.ReferencesWein AJ, et al. Campbell-Walsh Urology. 9th ed. St. Louis, Mo: WB Saunders; 2007.Goldman L, Ausiello D, et al. Cecil Textbook of Medicine, 22nd ed. Philadelphia, Pa: WB Saunders; 2004:741-742.

Acute bilateral obstructive uropathy?

DefinitionAcute bilateral obstructive uropathy is a sudden blockage of the flow of urine from both kidneys. The kidneys continue to produce urine in the normal manner, but because urine does not drain properly, the kidneys start to swell.See also:Chronic unilateral obstructive uropathyChronic bilateral obstructive uropathyAcute unilateral obstructive uropathyAlternative NamesUrethral obstruction; Acute urethral obstruction; Obstructive uropathy - bilateral - acuteCauses, incidence, and risk factorsIn men, acute bilateral obstructive uropathy is most often a result of an enlarged prostate. Other causes in men include:Bladder cancerKidney stonesProstate cancerAcute bilateral obstructive uropathy is much less common in women, but may be due to:Bladder cystoceleCervical cancerInjury from surgery involving the reproductive organsPregnancyOther causes in men and women include:Blood clotsNeurogenic bladderOther rare retroperitoneal processesPapillary necrosisPosterior urethral valves in infant boysAcute bilateral obstructive uropathy occurs in about 5 out of 10,000 people.SymptomsAbnormal urine flow -- dribbling at the end of urinationBlood in the urineBurning or stinging with urinationDecrease in the force of the urinary stream, stream small and weakDecreased urine output (may be less than 10 mL per day)Feeling of incomplete emptying of the bladderFeverFrequent strong urge to urinateRecent increase in blood pressureLeakage of urine (incontinence)Nausea and vomitingNeed to urinate at nightSudden flank pain or pain on both sidesUrinary hesitancyUrine, abnormal colorSigns and testsThe doctor will perform a physical exam. The exam may show:Large and full bladderSwollen or tender kidneysEnlarged prostate (men)There may be signs of chronic kidney failure, high blood pressure, and infection. Fever is common with an infection.Tests that may be done include:Arterial blood gas and blood chemistriesBasic metabolic panel -- will reveal kidney function and electrolyte balanceBlood BUNCreatinine clearanceComplete blood countPotassium testSerum creatinine testUrinalysis and a urine culture (clean catch)Ultrasound of the bladderUroflowmetryThe following tests may show hydronephrosis (swelling of kidneys):IVPRenal scanUltrasound of the kidneysAbdominal CT scanTreatmentThe goal of treatment is to relieve the blockage, which will allow urine to drain from the urinary tract. You may need to stay in a hospital for a short while.Short-term treatment may include:Antibiotics and other medications to treat symptomsCatheterization-- the placement of a tube into the body to drain urine (See: Urinary catheters)Long-term treatment involves correcting the cause of the blockage. This may involve:Surgery such as transurethral resection of the prostate (TURP)Laser or heat therapy to shrink the prostate if the problem is due to an enlarged prostateSurgery may also be needed for other disorders that cause blockage of the urethra or bladder neck.Expectations (prognosis)If the acute obstruction is quickly relieved, symptoms usually go away within hours to days. If untreated, the disorder causes progressive damage to the kidneys. It may eventually lead to high blood pressureor kidney failure.ComplicationsAcute kidney failureChronic bilateral obstructive uropathyHigh blood pressureReflux nephropathyUrinary tract infectionUrinary retention or incontinenceCalling your health care providerCall your health care provider if you have decreased urine output, difficulty urinating, flank pain, or other symptoms of acute bilateral obstructive uropathy.PreventionYou may not be able to prevent this condition. Routine annual physicals with a primary care doctor are recommended. If your doctor finds you have acute obstructive uropathy, you should be referred to the nearest emergency room and seen by a urologist.ReferencesPais VM Jr, Strandhoy JW, Assimos DG. Pathophysiology of urinary tract obstruction. 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.

Acute unilateral obstructive uropathy?

DefinitionAcute unilateral is a sudden blockage in one of the tubes (ureters) that drain urine from the kidneys.See also:Acute bilateral obstructive uropathyChronic unilateral obstructive uropathyChronic bilateral obstructive uropathyObstructive uropathyAlternative NamesObstructive uropathy - unilateral - acute; Ureteral obstructionCauses, incidence, and risk factorsUnilateral obstructive uropathy is most often caused by a kidney stone, although injury or other conditions could cause the disorder.When urine flow is blocked, it backs up into the kidney. This leads to kidney swelling, also called hydronephrosis.You have a greater risk for unilateral obstructive uropathy if you have ureteral stones and tumors, kidney stones, and tumors in nearby body structures such as the uterus and cervix.Acute unilateral obstructive uropathy occurs in 1 in 1,000 people.SymptomsAbdominal pain,right or left lower quadrantAbnormal urine color (tan, cola colored, tea colored)Back pain, may be on only one sideBlood in the urineFeverFlank pain or pain in the sideSevere enough to require strong pain medicinePain on one side; it may move to the groin, genitals, and thighPain comes and goes; intensity changes over minutesFoul-smelling urineHigh blood pressure that has increased recently (within 2 weeks)Mental status changesNauseaUrinary frequencyUrinary urgencyUrinary tract infectionVomitingSigns and testsThe health care provider will perform a physical exam. Pressing with the fingers on (palpation of) the belly area may reveal a swollen or tender kidney. Blood pressure may be high.The following tests may be done:Basic metabolic panelComplete blood count (CBC)UrinalysisUrine cultureKidney swelling or blockage of the ureter may be seen on these tests:Abdominal CT scanAbdominal ultrasoundIntravenous pyelogram (IVP)Kidney scanTreatmentThe goal of treatment is to relieve or reduce the blockage.Antibiotics may be given if there is a urinary tract infection.Stents or drains placed in the ureter or nearby area may provide short-term relief of symptoms. Surgery to repair the underlying cause of the obstruction will usually cure the problem.Kidney surgery, including removal of the kidney (nephrectomy) may be needed if kidney function is poor or if there is a bad infection.Expectations (prognosis)The outcome varies. The disorder may result in permanent damage to the kidney. However, kidney failure usually does not result because the second kidney continues to function.ComplicationsChronic or recurrent urinary tract infectionChronic unilateral obstructive uropathyHypertensionPermanent failure of the affected kidney (chronic renal failure)Calling your health care providerCall your health care provider if you develop flank pain or other symptoms of acute unilateral obstructive.Call your health care provider if symptoms worsen during or after treatment, or if new symptoms develop.PreventionIf you are prone to kidney stones, drink plenty of water (6 to 8 glasses per day) to reduce the chance 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 come back to identify the cause and to prevent new stones from forming.ReferencesPeters CA. Perinatal urology. In: Wein AJ, ed. Campbell-Walsh Urology. 9th ed. Philadelphia, Pa: Sauders Elsevier; 2007: chap 109.Pais VM, Strandhoy JW, Assimos DG. Pathophysiology of urinary tract obstruction. In: Wein AJ, ed. Campbell-Walsh Urology. 9th ed. Philadelphia, Pa: Sauders 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: Sauders Elsevier; 2007: chap 38.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.

Renal papillary necrosis?

DefinitionRenal papillary necrosis is a disorder of the kidneys in which all or part renal papillae die. The renal papillae is the area where the openings of the collecting ducts enter the kidney.Alternative NamesNecrosis - renal papillae; Renal medullary necrosisCauses, incidence, and risk factorsRenal papillary necrosis is most commonly associated with analgesic nephropathy. However, a number of conditions can cause this condition, including:Diabetic nephropathyKidney infectionKidney transplant rejectionUrinary tract obstructionSickle cell anemiaSickle cell anemia is a common cause of renal papillary necrosis in children.SymptomsNecrosis (tissue death) of the renal papillae may make the kidney unable to concentrate the urine. Symptoms may include:Back pain or flank painBloody urineCloudy urineDark, rust-colored, or brown urineTissue in the urineAdditional symptoms that may be associated with this disease:ChillsIncontinenceIncreased urinary frequency or urgencyPainful urinationPassing large amounts of urineUrinating frequently at nightUrinary hesitancySigns and testsAn examination may reveal tenderness when touching the body over the affected kidney. There may be a history of chronic or recurrent urinary tract infections. There may be signs of obstructive uropathy or renal failure.A urinalysis may show dead tissue in the urine.An IVP may show obstruction or tissue in the renal pelvis or ureter.TreatmentThere is no specific treatment for renal papillary necrosis. Treatment depends on the underlying cause. For example, if analgesic nephropathy is suspected as the cause, your doctor will recommend that you stop using the suspected medications. This may allow healing over time.Expectations (prognosis)How well a person does depends on the underlying condition. If the underlying disorder can be controlled, the condition may go away on its own. In some cases, persons with this condition develop kidney failure.ComplicationsAcute kidney failureChronic kidney failureAcute unilateral obstructive uropathyChronic unilateral obstructive uropathyAcute bilateral obstructive uropathyChronic bilateral obstructive uropathyChronic or recurrent UTIHyperkalemiaHypovolemiaMetabolic acidosisCalling your health care providerCall for an appointment with your health care provider if you have bloody urine. Also call if other symptoms of renal papillary necrosis develop, especially after taking over-the-counter pain medications.PreventionControl of diabetes or sickle cell anemia may reduce risk. Prevention of renal papillary necrosis from analgesic nephropathy includes careful moderation in the use of medications, including over-the-counter analgesics.

What is urine theropy and why would anybody drink urine?

Urine therapy, also known as uropathy, involves the consumption or topical application of urine for purported health benefits. Proponents claim that it can boost the immune system, improve skin conditions, and detoxify the body, although scientific evidence supporting these claims is lacking. Some individuals may turn to urine therapy as a natural remedy or alternative treatment when conventional medicine does not meet their needs. However, health professionals generally advise against it due to potential risks and the absence of proven benefits.

Is there any relation between an ovarian cyst a yeast infection or an urinary tract infection?

Hi there, Yes, in my view there may be a relationship between an ovarian cyst and a urinary tract infection, for example as follows: Someone may get a UTI because the ovarian cyst is compressing the ureter inside the pelvis. Compression may cause what is known as an 'obstructive uropathy' and this may be intermittent (as the cyst changes position in the pelvic cavity) and also partial i.e. not complete (the flow of urine through the ureter is not completely stopped). In turn, this type of compression can cause urinary stasis, and so predispose the person to a urinary tract infection. I do not know how common this is in reality. However, I would say it is possible and I have certainly noted some patients presenting with with urinary tract infections, which could be related to their cyst in this way. However, given that urinary tract infections are fairly common, especially in women, it is difficult to be sure if these women who have a cyst and concomitant UTI, have the infection for the aforementioned reason. In any case, a doctor would usually treat a UTI regardless of the cause, to prevent the development of complications such as a renal infection (pylonephritis). With regards to any relationship between an ovarian cyst and a yeast infection, I would think this less likely. Best wishes, Scottish Doctor.

Nephrocalcinosis?

DefinitionNephrocalcinosis is a disorder in which there is excess calcium deposited in the kidneys.Causes, incidence, and risk factorsAny disorder that leads to high levels of calcium in the blood or urine may lead to nephrocalcinosis. In nephrocalcinosis, calcium deposits form in the kidney tissue itself. Most of the time, both kidneys are affected.Nephrocalcinosis is related to, but not the same as, kidney stones(nephrolithiasis).Conditions that can cause nephrocalcinosis include:Alport syndomeBartter syndromeChronic glomerulonephritisMedullary sponge kidneyPrimary hyperoxaluriasRenal transplant rejectionRenal tubular acidosisRenal cortical necrosisOther possible causes of nephrocalcinosis include:Ethylene glycol toxicityHypercalcemia(excess calcium in the blood) due to hyperparathyroidismUse of certain medications, such as acetazolamide, amphotericin B, and triamtereneTuberculosis of the kidney and infections related to AIDSVitamin D toxicityThis condition is relatively common in premature infants.SymptomsThere are generally no early symptoms of nephrocalcinosis, beyond those of the condition causing the problem.People who also have kidney stones may have:Blood in the urineFever and chillsNausea and vomitingSevere pain in the belly area, sides of the back (flank), groin, or testiclesLater symptoms related to nephrocalcinosis may be associated with chronic kidney failure.Signs and testsNephrocalcinosis may be discovered when symptoms of renal insufficiency, kidney failure, obstructive uropathy, or urinary tract stonesdevelop.Imaging tests can help diagnose this condition. Tests that may be done include:Abdominal CT scanUltrasound of the kidneyOther tests that may be done to diagnose and determine the severity of associated disorders include:Blood tests to check levels of calcium, phosphate, uric acid, and parathyroid homroneUrinalysis to see crystals and check for red blood cells24-hour urine collection to measure acidity and levels of calcium, sodium, uric acid, oxalate, and citrateTreatmentThe goal of treatment is to reduce symptoms and prevent more calcium from being deposited in the kidneys.Measures should be taken to reduce abnormal levels of calcium, phosphate, and oxalate in the blood. Medications that cause calcium loss will usually be stopped.Conditions that result from the disorder should be treated as appropriate.Kidney stonesshould be treated.Expectations (prognosis)What to expect depends on the extent of complications and the cause of the disorder.Although further deposits in the kidneys can be prevented with good treatment, deposits already formed usually cannot be eliminated. Extensive deposits of calcium in the kidneys does NOT always mean severe damage to the kidneys.ComplicationsAcute renal failureChronic renal failureKidney stonesObstructive uropathy (acute or chronic, unilateral or bilateral)Calling your health care providerCall your health care provider if you know you have a disorder that causes high levels of calcium in your blood and you develop symptoms of nephrocalcinosis.PreventionPrompt treatment of disorders that lead to nephrocalcinosis, including renal tubular acidosis, may help prevent it from developing.ReferencesMonk RD, Bushinsky DA. Kidney Stones. In: Kronenberg HM, Melmed, S, Polonsky KS, Larsen PR, eds. Williams Textbook of Endocrinology. 11th ed. Philadelphia, Pa: Saunders Elsevier; 2008: chap 29.Nephrolithiasis and nephrocalcinosis. In: Feehally J, Floege J, Johnson RJ, eds. Comprehensive Clinical Nephrology. 3rd ed. Philadelphia, Pa: Mosby Elsevier; 2007.

Stent?

DefinitionA stent is a tiny tube placed into an artery, blood vessel, or other duct (such as one that carries urine) to hold the structure open.Alternative NamesDrug-eluting stents; Urinary or ureteral stents; Coronary stentsDescriptionWhen a stent is placed into the body, the procedure is called stenting. There are different kinds of stents. Most are made of a metal or plastic mesh-like material. However, stent grafts are made of fabric. They are used in larger arteries.An intraluminal coronary artery stent is a small, self-expanding, metal mesh tube that is placed inside a coronary artery after balloon angioplasty to prevent the artery from re-closing.A drug-eluting stent is coated with a medicine that helps further prevent the arteries from re-closing. Like other coronary stents, it is left permanently in the artery.Why the Procedure Is PerformedMost of the time, stents are used to treat conditions that result when arteries become narrow or blocked. The devices are also used to unblock and keep open other tube-shaped structures in the body, including the bile ducts, the ureters (the tubes that drain urine from the kidneys to the bladder) and bronchi (the small airways in the lungs).Stents are commonly used to treat the following conditions that result from blocked or damaged blood vessels:Coronary heart disease (CHD) (angioplasty and stent placement - heart)Peripheral artery disease (angioplasty and stent replacement - peripheral arteries)Renal artery stenosisAbdominal aortic aneurysm (aortic aneurysm repair - endovascular)Carotid artery disease (carotid artery surgery)Other reasons to use stents include:Keeping open a blocked or damage ureter (percutaneous urinary procedures)Treating aneurysms, including thoracic aortic aneurysmsKeeping bile flowing in blocked bile ducts (biliary stricture)Helping you breathe if you have a blockage in the airwaysRisksSee also:Angioplasty and stent placement - heartAngioplasty and stent placement - peripheral arteriesPercutaneous urinary proceduresTransjugular intrahepatic portosystemic shunt (TIPS)Carotid artery surgeryAortic aneurysm repair - endovascularThoracic aortic aneurysmReferencesTeirstein PS. Percutaneous coronary intervention. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 73.Zeidel ML. Obstructive uropathy. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 124.

Bladder outlet obstruction?

DefinitionBladder outlet obstruction (BOO) is a blockage at the base of the bladder that reduces or prevents the flow of urine into the urethra, the tube that carries urine out of the body.Alternative NamesBOO; Lower urinary tract obstruction; ProstatismCauses, incidence, and risk factorsBladder outlet obstruction (BOO) can have many different causes, including:Benign prostatic hyperplasia (BPH), or enlarged prostateBladder stonesBladder tumors (cancer)Pelvic tumors (cervix, prostate, uterus, rectum)Urethral stricture (scar tissue)Less common causes include:CystoceleForeign objectsPosterior urethral valves (congenital birth defect)Urethral spasmsUrethral diverticulaThis condition is most common in aging men. It is often caused by BPH. Bladder stones and bladder cancer are also more commonly seen in men than women. As a man ages, the chance of developing these diseases increases dramatically.See also:Benign prostatic hypertrophyBladder stonesObstructive nephropathyReflux nephropathySymptomsThe symptoms of bladder outlet obstruction may vary, but can include:Abdominal painContinuous feeling of a full bladderDelayed onset of urination (urinary hesitancy)Frequent urinationInability to urinate (acute urinary retention)Pain on urination (dysuria)Slow urine flowUrinary tract infectionUrine stream starts and stops (urinary intermittency)Waking up at night to urinate (nocturia)Signs and testsIf bladder outlet obstruction is suspected, your health care provider will take a thorough history of your problems. During a physical exam, your provider may find one or more of the following possible causes:Abdominal massCystocele (women)Distended bladderEnlarged prostate (men)Tests may include:Blood chemistries to look for signs of kidney damageCystoscopy and retrograde urethrogram (x-ray) to look for narrowing of the urethraUltrasound to locate the blockage of urineand find out how well the bladder emptiesUrinalysis to look for blood or signs of infection in the urineUrine culture to check for an infectionUroflowmetry to determine how fast urine flows out of the bodyUrodynamic testing to see how much the urine flow is blocked and how well the bladder contractsTreatmentTreatment of bladder outlet obstruction depends on the cause of the problem. For most cases, a tube, called a catheter, inserted through the urethra into the bladder, will relieve the obstruction temporarily.Occasionally, a suprapubic catheter (a tube placed through the belly area into the bladder) is needed to drain the bladder.Long-term treatment of bladder outlet obstruction usually involves surgery. However, medical treatment options are available for many of the diseases that cause this problem. Discuss treatment options with your health care provider.Expectations (prognosis)If diagnosed early, most causes of bladder outlet obstruction can be treated with great success. However, if diagnosis is delayed, permanent damage can result.ComplicationsLong-term or high-grade bladder outlet obstruction can permanently damage all parts of the urinary system.Complications include:Bladder and kidney stonesKidney failureRecurrent urinary tract infectionsUrinary incontinenceUrinary retentionCalling your health care providerIf you have symptoms of bladder outlet obstruction, call your provider. Early diagnosis is important and can often lead to a simple and effective cure.PreventionThe condition may be prevented by identifying and treating the cause of the blockage.ReferencesWein AJ, ed. Campbell-Walsh Urology. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2007.Tseng TY, Stoller ML. Obstructive uropathy. Clin Geriatr Med. 2009 Aug;25(3):437-43.

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