Urethral obstruction
Key points
- Acute bilateral obstructive uropathy is a sudden blockage of the flow of urine from both kidneys, which can cause the backup of urine and injure the kidneys.
- Obstructive uropathy occurs when the flow of urine is blocked.
- Signs and tests Examination by touch (palpation) shows enlarged and tender kidneys.
- Treatment is focused on relieving the obstruction, which will allow urine to drain from the urinary tract.
Alternative names
Acute bilateral obstructive uropathy; Acute urethral obstruction; Obstructive uropathy - bilateral - acute
Definition
Acute bilateral obstructive uropathy is a sudden blockage of the flow of urine from both kidneys, which can cause the backup of urine and injure the kidneys.
Causes, incidence, and risk factors
Obstructive uropathy occurs when the flow of urine is blocked. The kidneys continue to produce urine in the normal manner, but the urine does not drain properly because of the obstruction. Pressure in the urinary tract rises, resulting in hydronephrosis (swelling of the kidneys) and bilateral obstructive uropathy (damage to both kidneys caused by obstruction of urine). Obstructive uropathy may eventually lead to hypertension or acute renal failure. Sudden blockage causes acute bilateral obstructive uropathy, while slow, progressive blockage causes chronic bilateral obstructive uropathy.
Acute bilateral obstructive uropathy is usually caused by a blockage of the urethra that occurs (suddenly or over a brief time). In men, it is most often a result of an enlarged prostate. Other causes in men include prostate cancer, bilateral obstructing kidney stones and bladder cancer. It is much less common in women, but may occur as a result of a bladder cystocele, pregnancy, injury from surgery involving the reproductive organs, or cervical cancer. Other causes include posterior urethral valves in infant boys, neurogenic bladder, papillary necrosis, coagulated blood, fungus and other rare retroperitoneal processes.
At first, the bladder reacts to the obstruction with increased irritability. There is a stronger and more frequent urge to urinate, and bladder spasms or incontinence may occur. As urine accumulates, it may lead to stasis of urine and urinary tract infections (see UTI - acute). Urine may back up into the ureters (tubes which carry urine from the kidneys to the bladder) and kidney.
Acute bilateral obstructive uropathy occurs in about 5 out of 10,000 people.
Symptoms
- Decreased urine output (may be less than 10 mL per day)
- Urinary hesitancy
- Abnormal urine flow - dribbling at the end of urination
- Incontinence
- Decrease in the force of the urinary stream, stream small and weak
- Increased urinary frequency or urgency
- Need to urinate at night
- Frequent strong urge to urinate
- Burning or stinging with urination
- Feeling of incomplete emptying of the bladder
Written and revised by
Andrey Nailor, M.D.
Our doctors write and review articles for accuracy and keep them up to date.
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