Acute bilateral obstructive uropathy

Bladder catheterization, female

A catheter (a hollow tube, often with an inflatable balloon tip) may be inserted into the urinary bladder when there is a urinary obstruction, following surgical procedures to the urethra, in unconscious patients (due to surgical anesthesia, coma, etc.), or for any other problem in which the bladder needs to be kept empty (decompressed) and urinary flow assured.

Also known as: Urethral obstruction, Acute urethral obstruction or Obstructive uropathy - bilateral - acute

Definition

Acute 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:

Causes, incidence, and risk factors

In men, acute bilateral obstructive uropathy is most often a result of an enlarged prostate. Other causes in men include:

  • Bladder cancer
  • Kidney stones
  • Prostate cancer

Acute bilateral obstructive uropathy is much less common in women, but may be due to:

  • Bladder cystocele
  • Cervical cancer
  • Injury from surgery involving the reproductive organs
  • Pregnancy

Other causes in men and women include:

  • Blood clots
  • Neurogenic bladder
  • Other rare retroperitoneal processes
  • Papillary necrosis
  • Posterior urethral valves in infant boys

Acute bilateral obstructive uropathy occurs in about 5 out of 10,000 people.

Symptoms

Signs and tests

The doctor will perform a physical exam. The exam may show:

  • Large and full bladder
  • Swollen or tender kidneys
  • Enlarged 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:

The following tests may show hydronephrosis (swelling of kidneys):

Treatment

The 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 symptoms
  • Catheterization-- 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 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 pressure or kidney failure.

Complications

Calling your health care provider

Call your health care provider if you have decreased urine output, difficulty urinating, flank pain, or other symptoms of acute bilateral obstructive uropathy.

Prevention

You 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.

References

Pais 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.

Frøkiaer 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.

See also:

  • Symptoms

    Urinary incontinence

    Female urinary tract

    Urinary (or bladder) incontinence is when you are not able to keep urine from leaking from your urethra, the tube that carries urine out of your body from your bladder. It can range from an occasional leakage of urine, to a complete inability to hold any urine. The three main types of urinary ...

  • Disease

    Acute kidney failure

    Kidney anatomy

    Acute (sudden) kidney failure is the sudden loss of the ability of the kidneys to remove waste and concentrate urine without losing .

  • Disease

    Cystitis - acute

    Female urinary tract

    Acute cystitis is a bacterial infection of the bladder or lower urinary tract. Acute means sudden or severe. See also:

  • Disease

    Unilateral hydronephrosis

    Female urinary tract

    Unilateral hydronephrosis is swelling of one kidney due to a backup of urine. See also:

  • Disease

    Stress incontinence

    Female urinary tract

    Stress incontinence is an involuntary loss of urine that occurs during physical activity, such as coughing, sneezing, laughing, or exercise.

  • Symptoms

    Frequent or urgent urination

    Female urinary tract

    Frequent urination means needing to urinate more often than usual. Urgent urination is a sudden, compelling urge to urinate, along with discomfort in your bladder. A frequent need to urinate at night is called . Most people can sleep for 6 to 8 hours without having to urinate. Middle aged and ...

  • Disease

    Reflux nephropathy

    Voiding cystourethrogram

    Reflux nephropathy is a condition in which the kidneys are damaged by the backward flow of urine into the kidney.

  • Disease

    Hypertension

    Blood pressure check

    Hypertension is the term used to describe high blood pressure. Blood pressure is a measurement of the force against the walls of your arteries as the heart pumps blood through the body. Blood pressure readings are measured in millimeters of mercury (mmHg) and usually given as two numbers — ...

  • Disease

    Chronic bilateral obstructive uropathy

    Bladder catheterization, female

    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:

Review date:
March 22, 2010
Reviewed by:
Linda J. Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington, School of Medicine; Scott Miller, MD, Urologist in private practice in Atlanta, Georgia. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc
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