Ureteric Obstruction

Causes

There are many potential causes of ureteric obstruction, including:

• Kidney stones: These are the most common cause of ureteric obstruction. When minerals in the urine crystallize and form hard masses, they can lodge in the ureters and block the flow of urine.
• Blood clots: These can form in the ureters due to various conditions, such as kidney infections, injuries, or certain cancers.
• Strictures: These are narrowings in the ureters that can be caused by scarring from infections, surgery, or radiation therapy.
• Tumors: Benign (noncancerous) or malignant (cancerous) tumors in the ureters, bladder, or pelvis can compress the ureters and cause obstruction.
• Ureteroceles: These are small pouches that form in the ureter where it connects to the bladder. They can block the flow of urine.
• Retroperitoneal fibrosis: This is a rare condition in which fibrous tissue grows behind the abdomen and compresses the ureters.

Symptoms

The symptoms of ureteric obstruction can vary depending on the severity of the blockage and whether one or both ureters are affected. Common symptoms include:

• Severe pain in the flank (side or lower back) on the affected side, which may radiate to the groin or lower abdomen
• Painful urination (dysuria)
• Urgent need to urinate (urgency)
• Frequent urination (frequency)
• Difficulty urinating (hesitancy)
• Blood in the urine (hematuria)
• Nausea and vomiting
• Fever and chills (if an infection is present)

Diagnosis

If you are experiencing any of the symptoms of ureteric obstruction, it is important to see a doctor right away. Early diagnosis and treatment can help prevent complications. Diagnosis of ureteric obstruction may involve:

• Urinalysis and urine culture: To check for signs of infection or blood in the urine
• Blood tests: To assess kidney function
• Imaging tests: X-rays, ultrasounds, CT scans, or MRIs to visualize the ureters and identify the blockage

Treatment

The treatment for ureteric obstruction depends on the cause and severity of the blockage. Treatment options may include:

• Pain medication: To relieve pain
• Hydration: To increase urine flow and help flush out the blockage
• Medications: Antibiotics to treat infections or medications to relax the ureters
• Lithotripsy: A procedure that uses shock waves to break up kidney stones
• Ureteroscopy: A procedure where a thin, lighted tube is inserted into the ureter to remove the blockage 
• Stenting: A small tube is placed in the ureter to keep it open (Click here to read more on Antegrade ureteric stenting)
• Surgery: In some cases, surgery may be necessary to remove the blockage or repair a narrowed ureter

Complications

If left untreated, ureteric obstruction can lead to serious complications, including:

• Kidney infection: Urine that backs up into the kidneys can increase the risk of infection.
• Hydronephrosis: This is a condition in which the kidney swells due to a buildup of urine.
• Kidney damage: Chronic obstruction can permanently damage the kidneys and lead to kidney failure.

Prevention

There is no guaranteed way to prevent ureteric obstruction, but you can take steps to reduce your risk, such as:

• Drinking plenty of fluids to help flush out the kidneys
• Maintaining a healthy diet to reduce your risk of kidney stones
• Seeing your doctor for regular checkups, especially if you have a history of kidney stones or urinary tract infections