Ureteric Obstruction: Causes and Treatment

Ureteric Obstruction

The ureters are responsible for carrying urine from the kidneys to the bladder; any obstruction in this pathway can lead to what is known as ‘ureteric obstruction’. The symptoms of the obstruction are mild but can turn serious if the obstruction is not dealt with.

Initially, the ureteric obstruction can present without signs and symptoms. Later, there can be flank pain on the affected side, difficulty in urination, changes in the amount of urine produced, blood in urine, high blood pressure or repeated urinary tract infections.

For anyone suffering from these signs and symptoms, a consultation from the best Urologist in Lahore can be very helpful in preventing serious complications.

What are the causes of ureteric obstruction?

Various internal and external conditions result in ureteric obstruction.

Kidney stones: The most common cause of ureteric obstruction in both men and women, is kidney stones. Kidney stones can obstruct the passage of urine, especially when they occur in the ureteropelvic junction (the part of the kidney where the ureters originate).

Enlarged prostate (BPH): the second most common cause of ureteric obstruction is benign prostatic hyperplasia, seen mostly in men over the age of 60 years.

 Congenital causes: include abnormal insertion site of the ureter in the kidney, or a blood vessel that crosses in front of the ureter obstructing its flow.

Tumor: cancers of the kidney or the surrounding structures can press on the ureter(s) and interrupt the flow of urine.

Scar tissue: for people with prior history of surgery, scar tissue in the ureter can prove problematic. This can also result from a birth defect.

Genetic disorder: some genetic disorders can cause narrowing of the ureteric diameter (ureteric structure).

How to treat ureteral obstruction?

 In most cases, the healthcare provider runs a number of tests to find the anatomical position of the obstruction. These include non-invasive investigations like ultrasound, CT scan or an MRI. Additional tests may be needed as per the individual’s requirements.

The treatment options are designed according to the causes of obstruction. The first priority is to get the urine to flow out of the body uninterrupted; for this, a urinary catheter may be placed in the bladder. Other options include inserting a ureteral stent which holds the ureter open to allow free passage of urine. Alternatively, a catheter can be placed in the kidney through an opening called nephrostomy and then inserting a catheter into the opening and draining the urine directly from the kidney.

Other options:

Ureteric obstruction can also be treated with the help of medication. Depending upon the cause, if BPH is the reason for ureteric obstruction, medication called alpha-blockers help to relax the neck of the bladder and allow full voiding of urine. Other drugs like finasteride cause shrinking of the prostate, so it no longer compresses on the urinary bladder.

Surgical correction helps to relieve the obstruction if an anatomical defect is the culprit. In most cases that need surgical correction, it’s a congenital anomaly that’s causing the ureteric obstruction. Resection of tumors or growths that are pressing on the ureters also relieves the obstruction, and helps the patient get back to normal voiding. Therapeutic stents are also used by the best Urologist in Karachi to keep the ureters open and propel the urine from the kidneys.

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