Obstructive uropathy - unilateral - acute

Alternative names

Acute unilateral obstructive uropathy; Ureteral obstruction

Definition

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

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

• Flank pain or pain in the side
  o Severe
  o May travel or radiate to the groin, genitals, thigh
  o Periodic and changing intensity over minutes (colicky) or spasmodic
  o On one side
  o Severe enough to require narcotics
  o Radiating to groin
  
• nausea or vomiting
  
• Back pain, may be on only one side
  
• Abdominal pain, right or left lower quadrant
  
• Blood in the urine
  
• Abnormal urine color (tan, cola colored, tea colored)
  
• high blood pressure that has increased recently (within 2 weeks)
  
• Urinary tract infection
  
• Fever
  
• Urinary frequency
  
• Urinary urgency
  
• Foul-smelling urine
  
• Mental status changes