Introduction to acute unilateral obstructive uropathy
Urine, when formed, leaves the two kidneys to the bladder through two ‘pipes’ called ureters. When these pipes are blocked, urine won’t be able to get to the bladder. If it is just one of the pipes that get blocked, it is referred to as unilateral. When the blockage happens suddenly, it is described as acute. Since it is not the two pipes that are blocked, the other one can continue making up for the affected one.
Acute unilateral obstructive uropathy is rare. National Institutes of Health puts the statistics at 1 in every 1000 people.
Causes of acute unilateral obstructive uropathy
Kidney stones! It is the top cause of acute unilateral obstructive uropathy. Now, these stones are not the normal stones you have always known. They are hardened mineral deposits in the kidney. They are not big in size. They enter the ureters and obstruct them. They are not limited to just the ureters. They can occlude any other pipe-like structure in the kidney.
An occluded ureter will hence allow urine to be stored in the kidney for as long as the stones are there. When this urine remains there, it begins to raise the pressure in the kidney. The pressure alone can completely damage the kidney.
The not-too-common causes include:
- injuries to the kidney tissues
- cancerous cells in the ureters and its surrounding organs such as uterus, bladder, colon or cervix
- scar tissues right one of the ureters
Photo Credit: UF Health
Symptoms of acute unilateral obstructive uropathy
Since it is just one of the pipes that are blocked, you will still pass urine. The normal volume might be maintained. But you should be on the lookout for blood in the urine. The urine can also be smelly. The color of the urine will also be changed to brown or tan.
Some pains can also be experienced. If kidney stones are the reason for the blockage, back and abdominal pains will be prominent. The pain can be intense for a while and mild for another while. One interesting thing about this pain is its ability to project to other body areas especially the groins and thigh.
Aside from those characteristic features of the urine and pains, other symptoms have been identified with acute unilateral obstructive uropathy. They are: fever, raised arterial blood pressure and vomiting.
Diagnosis of acute unilateral obstructive uropathy
Physical exam: The doctor will check for tenderness in your kidneys. He will also take your blood pressure.
Imaging tests: Your internal organs particularly the kidneys and urinary tract will be viewed for identification of blockages, injuries, and swellings. Some of the imaging tests to expect are:
- CT scanning of the abdomen.
- An abdominal ultrasound where sound waves are employed to produce the images of your abdomen.
- Intravenous Pyelogram: It uses a dye called contrast dye to take the X-rays of the ureter, kidneys, and bladder. From the X-rays, the doctor will observe how your kidneys eliminate the contrast dye. Its characteristic color in your urine will also be noted.
- Renal Scan: Your kidney function is measured using a radioactive dye injected into your body through one of the big veins in your arm. When your kidney is scanned, it is this radioactive dye that will be monitored for diagnostic assessments.
- Urinalysis: Your urine will be obtained in a small sample bottle and taken to the lab for analysis. From the test, indicators of a urinary tract or kidney diseases will be ascertained.
- Basic Metabolic Panel: Your blood sample will be taken for analysis of the functions of your kidney.
Treatment options for acute unilateral obstructive uropathy
Treatment options include minimizing the obstruction and improving symptoms.
This is aimed at giving you a temporary relief. A stent, that is, a not-too-big tube with a diameter corresponding to the ureter, will be placed in the ureter. This stent will keep the ureter open so that urine can flow through it.
Antibiotics will be needful if there is an infection.
This is for a long-term relief. All the underlying conditions will be diagnosed and treated accordingly. Surgery might be employed if the blockage is severe and needs to be extracted. The stones can scar the ureter so they have to be removed.
If the condition is prostate-induced, surgical means can as well be used to reduce the size of the prostate.
If it is cancer-induced, your doctor will give you treatment options available for cancer.
So long as the underlying causative disease has been identified and treated, mild forms of acute unilateral obstructive uropathy can be cured.
If the case is quite serious, permanent damage to your kidney is inevitable.
Kidney failure won’t occur because it’s just one kidney that has the problem. It will only be possible when both kidneys are bad and have stopped working.
This acute condition can advance to chronic unilateral obstructive uropathy. Hypertension might precipitate. You might also have recurring infections in your urinary tract.
Prevention of acute unilateral obstructive uropathy
If the formation of kidney stones can be prevented in the first place, there will be no worry of developing acute unilateral obstructive uropathy.
These are some of the known ways of preventing this:
Drink nothing less than six glasses of potable water every day. If you have kidney stones already, you might take more than this number of glasses.
Cut down on your oxalate and salt consumption. Oxalates are found in rhubarb, beets, spinach, soy products, and blackberries. You can find out more foods where they can be found from your doctor so as to check your consumption of such foods. Calcium oxalate stones are formed by oxalates.