A urinary tract obstruction (UTO) is any blockage that impairs the flow of urine through its normal path in the urinary tract, that is, from the kidneys where urine is produced, the ureters that link the kidneys to the bladder, and the urethra where urine passes out of the body.
Blockages may be partial or complete, develop slowly over time or emerge quickly; but timeous treatment is necessary to prevent complications resulting from blocked urine flow. These include kidney and bladder stones, infection, and urine reflux – where the urine passes back into the kidney, increasing pressure on internal structures, and possibly causing kidney damage.
UTO causes are varied and include:
- Structural abnormalities in the urinary tract
- Kidney and bladder stones
- Enlarged prostate
- Tumours in the pelvic region
- Ureteral polyps (benign tumours)
- Blood clots
- Diseases of the digestive tract
What are its symptoms?
Symptoms depend on the cause and location of the obstruction, and include the following:
- Increase (especially at night) or decrease in urine flow
- Pain in the side of the body
- Pain in the area between the ribs and hips extending into the testes (in men) and vagina (in women)
- Pain or pressure in the bladder
- Dull lower back pain
- Nausea and vomiting
- Pus in the urine
How is it diagnosed?
Making a diagnosis is aided by the following procedures and imaging tests:
- Bladder catheterisation: A thin, hollow tube is inserted into the urethra to drain urine from the bladder. Generally, an ultrasonography will be done prior to this procedure to determine how much urine is in the bladder.
- Imaging tests: These can help identify evidence of an obstruction or the site of the blockage. Ultrasonography is useful for this purpose, especially in children and during pregnancy, as it doesn’t expose the patient to radiation. A CT (computerised tomography) scan is a quick and accurate alternative, especially in identifying stones in the urinary tract. MRI (magnetic resonance imaging) scans are also useful if ultrasonography doesn’t identify the site of the obstruction.
- Endoscopy: A thin, flexible tube with a camera (cytoscope) can be used to examine the urethra, prostate and bladder, while a ureteroscope can be passed into the ureters or kidneys to identify sites of obstruction.
- Blood and urine tests: These can help determine if kidneys are affected or detect the presence of tumours.
What are your treatment options?
UTO treatment aims to relieve the obstruction, so its location and cause need to be determined. If the source of the obstruction is related to an enlarged prostate, for instance, surgery or hormone treatment may be necessary. If the obstruction is caused by stones, endoscopic surgery may be required.
In certain severe cases, where the obstruction cannot be immediately corrected or removed, the urinary tract may be drained using a ureteral stent.
Can it be prevented?
Preventing a urinary tract obstruction relies on identifying and treating the condition that is causing it. If you experience any symptoms relating to the urinary tract that are out of the ordinary, see your doctor for a check-up.
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