scholarly journals Acute Urinary Tract Obstruction

2015 ◽  
Vol 16 (3) ◽  
pp. 249-253
Author(s):  
Djordje Aleksic

AbstractThe kidneys are paired organs with the primary function of helping to remove toxins from the body and regulate water balance. They are vital to survival. After urine is produced in the kidneys, it must pass into the bladder, where it can be stored before being eliminated from the body through the urethra. Urinary tract obstruction is a common problem encountered by urologists, primary care physicians, and emergency medicine physicians. Urine can become obstructed at any point in this pathway. There are three groups of urinary tract obstructions: 1) obstruction of the urinary tract lumen; 2) obstruction of the urinary tract wall; and 3) extrinsic obstruction, which can press on the urinary tract lumen. An obstruction can be present from birth or develop later in life. The most common causes of obstruction include stones, strictures, tumours, and bladder dysfunction. These obstructions may result in the hydronephrosis of one or both kidneys, which, if left untreated, may lead to the deterioration of renal function. The goal of an initial treatment of urinary tract obstruction is to remove the obstruction. Later, we treat the cause that led to the obstruction. The bottom line is that all efforts should be made to preserve kidney function to avoid the need for dialysis or renal transplantation.

2021 ◽  
pp. 677-682
Author(s):  
Noah E. Canvasser ◽  
Jennifer G. Rothschild ◽  
Frederick J. Meyers ◽  
Christopher P. Evans

Both upper and lower urinary tract obstruction are prevalent in the palliative care setting. Although sometimes related to urological conditions, non-urological aetiologies are also seen. Common causes of lower urinary tract obstruction include benign prostatic hyperplasia in men, an underlying neurological condition, and advanced pelvic malignancy. In the acute setting, bladder decompression with a Foley catheter is the easiest and fastest way to resolve the problem. Common causes of upper urinary tract obstruction include nephrolithiasis and advanced malignancy. This chapter will address the evaluation and management of these common clinical issues.


2020 ◽  
Vol 21 (15) ◽  
pp. 5490 ◽  
Author(s):  
Satoshi Washino ◽  
Keiko Hosohata ◽  
Tomoaki Miyagawa

Partial or complete obstruction of the urinary tract is a common and challenging urological condition caused by a variety of conditions, including ureteral calculi, ureteral pelvic junction obstruction, ureteral stricture, and malignant ureteral obstruction. The condition, which may develop in patients of any age, induces tubular and interstitial injury followed by inflammatory cell infiltration and interstitial fibrosis, eventually impairing renal function. The serum creatinine level is commonly used to evaluate global renal function but is not sensitive to early changes in the glomerular filtration rate and unilateral renal damage. Biomarkers of acute kidney injury are useful for the early detection and monitoring of kidney injury induced by upper urinary tract obstruction. These markers include levels of neutrophil gelatinase-associated lipocalin (NGAL), monocyte chemotactic protein-1, kidney injury molecule 1, N-acetyl-b-D-glucosaminidase, and vanin-1 in the urine and serum NGAL and cystatin C concentrations. This review summarizes the pathophysiology of kidney injury caused by upper urinary tract obstruction, the roles played by emerging biomarkers of obstructive nephropathy, the mechanisms involved, and the clinical utility and limitations of the biomarkers.


2010 ◽  
pp. 4151-4161
Author(s):  
Muhammad M. Yaqoob ◽  
Islam Junaid

Obstructive nephropathy can manifest as either a sudden or an insidious decline in renal function, which can be can halted or even reversed by relief of obstruction. Obstruction can be due to anatomical or functional abnormalities of the urethra, bladder, ureter, or renal pelvis, which may be congenital or acquired, and it can also occur as a consequence of diseases extrinsic to the urinary tract. Although dilatation of the outflow system proximal to the site of obstruction is a characteristic finding, widening of the ureter and/or pelvicalyceal system does not necessarily indicate the presence of obstruction, and flow may be obstructed without such dilatation....


2007 ◽  
Vol 39 (2) ◽  
pp. 587-593 ◽  
Author(s):  
Richard Wang ◽  
Antonios H. Tzamaloukas ◽  
Emmanuel I. Agaba ◽  
Karen S. Servilla ◽  
Dorothy J. VanderJagt ◽  
...  

1957 ◽  
Vol 23 (4) ◽  
pp. 554-564 ◽  
Author(s):  
Neal S. Bricker ◽  
Edmond I. Shwayri ◽  
John B. Reardan ◽  
Don Kellog ◽  
John P. Merrill ◽  
...  

2019 ◽  
Vol 13 (03) ◽  
pp. 219-226
Author(s):  
Alison A Jackson ◽  
Pauline Siew Mei Lai ◽  
Aqtab Mazhar Alias ◽  
Nadia Atiya ◽  
Siti Nurkamilla Ramdzan ◽  
...  

Introduction: Diagnosis and management of urinary tract infection (UTI) are complex, and do not always follow guidelines. The aim of this study was to determine adherence to the 2014 Malaysian Ministry of Health guidelines for managing suspected UTI in a Malaysian primary care setting. Methodology: We retrospectively reviewed computerized medical records of adults with suspected UTI between July-December 2016. Excluded were consultations misclassified by the search engine, duplicated records of the same patient, consultations for follow-up of suspected UTI, patients who were pregnant, catheterised, or who had a renal transplant. Records were reviewed by two primary care physicians and a clinical microbiologist. Results: From 852 records, 366 consultations were a fresh episode of possible UTI. Most subjects were female (78.2%) with median age of 61.5 years. The major co-morbidities were hypertension (37.1%), prostatic enlargement in males (35.5%) and impaired renal function (31.1%). Symptoms were reported in 349 (95.4%) consultations. Antibiotics were prescribed in 307 (83.9%) consultations, which was appropriate in 227/307 (73.9%), where the subject had at least one symptom, and leucocytes were raised in urine full examination and microscopic examination (UFEME). In 73 (23.8%) consultations antibiotics were prescribed inappropriately, as the subjects were asymptomatic (14,4.6%), urine was clear (17,5.5%), or UFEME did not show raised leucocytes (42,13.7%). In 7 (2.3%) consultations appropriateness of antibiotics could not be determined as UFEME was not available. Conclusion: Several pitfalls contributed to suboptimal adherence to guidelines for diagnosis and management of suspected UTI. This illustrates the complexity of managing suspected UTI in older subjects with multiple co-morbidities.


2017 ◽  
Vol 49 (5) ◽  
pp. 617-622 ◽  
Author(s):  
E. Spaggiari ◽  
G. Faure ◽  
S. Dreux ◽  
I. Czerkiewicz ◽  
J. J. Stirnemann ◽  
...  

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