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Acute bilateral obstructive uropathy - Symptom

Alternative Names

Urethral obstruction; Acute urethral obstruction; Obstructive uropathy - bilateral - acute

Symptoms:

Abnormal urine flow -- dribbling at the end of urination
Blood in the urine
Burning or stinging with urination
Decrease in the force of the urinary stream, stream small and weak
Decreased urine output (may be less than 10 mL per day)
Feeling of incomplete emptying of the bladder
Fever
Frequent strong urge to urinate
Recent increase in blood pressure
Leakage of urine (incontinence)
Nausea and vomiting
Need to urinate at night
Sudden flank pain or pain on both sides
Urinary hesitancy
Urine, abnormal color

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:

Arterial blood gas and blood chemistries
Basic metabolic panel -- will reveal kidney function and electrolyte balance
Blood BUN
Creatinine clearance
Complete blood count
Potassium test
Serum creatinine test
Urinalysis and a urine culture (clean catch)
Ultrasound of the bladder
Uroflowmetry

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

Bladder catheterization, female

Bladder catheterization, male

Female urinary tract

Male urinary tract

Reviewed last on: 3/22/2010
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

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.

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