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Chronic bilateral obstructive uropathy

• Overview
• Symptoms
• Treatment
• Prevention

Alternative Names:

Obstructive uropathy - bilateral - chronic; Kidney failure - chronic blockage

Symptoms:

Symptoms depend on the time course 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 urinary infection)

Additional symptoms that may be associated with this disease:

• Nail problems
• High blood pressure
• Abnormal urine color

Signs and tests:

A physical exam may show swollen or tender kidneys. The bladder may be large and full. A rectal examination may reveal an enlarged prostate. Signs and symptoms of chronic renal failure may be present. Blood pressure may be high.

• A urinalysis and a urine culture (clean catch) may show a urinary tract infection .
• A CBC may show an increased white blood cell count  
• A basic metabolic panel will reveal patient's current kidney function as well as electrolyte balance, which may be abnormal.
• A bladder scan (ultrasound) may show a large amount of urine in the bladder after urinating (more than 50 mL).
• Uroflowmetry may reveal decreased urinary flow due to a swollen prostate (BPH).

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

• Abdominal ultrasound
• CT scan of abdomen and pelvis
• Renal scan

References:

Walsh PC. Campbell's Urology . 8th ed. St. Louis, Mo: WB Saunders; 2002:412. 

Goldman L, Ausiello D. Cecil Textbook of Medicine , 22nd ed. Philadelphia, Pa: WB Saunders; 2004:741-742.

• Review Date: 5/3/2006
• Reviewed By: Neil D. Sherman, MD, Urologist, Essex County, NJ. Review provided by VeriMed Healthcare Network.

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