acute bilateral obstructive uropathy
acute bilateral obstructive uropathy
A condition of relatively abrupt onset caused by urethral obstruction.Aetiology
Men—BPH, prostate cancer; women—bladder cystocele, bladder tumours, tumours or other structures of the bladder neck or urethra, kidney or bladder stones, cervical cancer, blood clots, neurogenic bladder; posterior urethral valves in male infants.
Clinical findings
Urinary urgency, bladder incontinence, urine stasis, urinary tract infections, urine reflux into ureters and kidney, leading to pyelonephritis and hydronephrosis, dribbling of urine, reduced stream, sensation of residual urine in bladder, urgency, haematuria, flank pain, nausea, vomiting.
Imaging
Renal ultrasound, abdominal CT, intravenous pyelography, renal scan.
Management
• Medical: catheterisation, antibiotics.
• Surgical: transurethral resection of prostate (TURP) or other procedures to manage an enlarged prostate; other procedures to manage bladder tumours or other pathology.
Complications (if not managed early)
Hypertension, renal failure.