Ureteral Obstruction

A ureteral obstruction happens when one or both of the tubes that carry urine from your kidneys to your bladder get blocked. This blockage is called a ureteral obstruction. These tubes are called ureters. This is a problem that can be treated.

If a ureteral obstruction isn't treated, the symptoms can get worse quickly. At first, you might have mild symptoms like pain, a fever, or an infection. But if the problem continues without treatment, the symptoms can become much more serious. These more serious symptoms could include losing the ability of your kidneys to work properly, a severe infection called sepsis, and even death in the worst cases.

Ureteral obstructions are fairly common, but because they are treatable, serious complications aren't very frequent.

Blockages in the tubes that carry urine from your kidneys (ureters) can sometimes cause no noticeable problems. However, if there are symptoms, they vary. Where the blockage is, whether it's a complete or partial blockage, how quickly it developed, and if it affects one or both kidneys all play a role.

Possible signs and symptoms include:

• Pain: This pain can range from mild to severe. If the pain is so intense that you can't find a comfortable position, it's important to get help right away. Pain that's accompanied by nausea and vomiting or fever and chills also needs immediate medical attention.

• Changes in how much urine you make: You might produce less urine than usual, or have other changes in your urination habits.

• Trouble urinating: This could mean difficulty starting or maintaining a steady flow of urine.

• Blood in your urine: Blood in the urine (hematuria) can be a sign of a serious problem.

• Urinary tract infections (UTIs): Blockages can make you more prone to infections in your urinary system.

• High blood pressure (hypertension): Sometimes, a blockage can lead to increased blood pressure.

If you have any of these symptoms, even if they seem minor, it's a good idea to schedule an appointment with your doctor. This is especially important if you experience severe pain, pain with nausea or vomiting, pain with fever or chills, or blood in your urine. Also, if you're having trouble passing urine, seek immediate medical care.

If you're concerned about any pain or other symptoms, schedule a visit with your doctor.

See a doctor right away if you're experiencing:

• Intense pain: Pain so bad you can't sit comfortably or find a position that relieves it.
• Pain with other symptoms: If your pain is accompanied by feeling sick to your stomach (nausea) and throwing up (vomiting). This could be a sign of a more serious problem. Also, pain along with a fever and shivering (chills) should be checked by a doctor.
• Blood in your urine: If you notice blood in your urine, it's important to see a doctor right away.
• Trouble urinating: If you're having difficulty urinating, don't delay getting medical attention. This could be a sign of a urinary tract infection or other problem that needs prompt treatment.

Remember, this information is for general knowledge only and doesn't replace advice from a medical professional. If you have any concerns about your health, always talk to your doctor.

Sometimes, a person's urinary system has problems with the ureters, the tubes that carry urine from the kidneys to the bladder. This can lead to a condition called ureteral obstruction, where urine can't flow properly.

Several things can cause ureteral obstruction. Here are some common reasons:

Congenital Issues (Present at Birth):

• Duplicated Ureter: Sometimes, a person is born with two ureters connected to one kidney instead of one. These extra ureters might be fully formed or only partly developed. If either ureter isn't working correctly, urine can build up in the kidney, potentially harming it.

• Blockages at the Kidney or Bladder Connection: A blockage can happen where the ureter connects to the kidney (ureteropelvic junction) or where it connects to the bladder (ureterovesical junction). These blockages prevent urine from flowing. A blockage at the kidney connection can cause the kidney to swell and even stop working. Blockages can be present from birth, develop as a child grows, result from injury, scarring, or, rarely, a tumor. A blockage at the bladder connection can cause urine to back up into the kidneys.

• Ureterocele: A ureterocele is a small bulge in the ureter, most often near the bladder. If the ureter is too narrow, this bulge can form and block the flow of urine, leading to backup in the kidney and possible kidney damage.

Other Causes:

• Retroperitoneal Fibrosis: This is a rare condition where fibrous tissue grows around the ureters, often due to certain tumors or medicines, causing blockage and urine backup.

Other Possible Causes (Inside or Outside the Ureter):

• Kidney Stones: Hard deposits in the kidneys can block the ureters.
• Tumors: Both cancerous and non-cancerous tumors can grow and block the ureters.
• Blood Clots: Blood clots can sometimes block the ureters.
• Enlarged Lymph Nodes: Swollen lymph nodes can press on the ureters, hindering urine flow.
• Internal Tissue Growth: Conditions like endometriosis (in women) can cause extra tissue growth that blocks the ureters.
• Ureter Inflammation: Long-term inflammation of the ureter, often due to diseases like tuberculosis or a parasitic infection called schistosomiasis, can cause blockage.

These are some of the reasons why urine might not flow freely through the ureters. If you're concerned about problems with your urinary system, it's important to talk to a doctor.

Some babies are born with things that can make it more likely for their tubes (ureters) that carry urine from the kidneys to the bladder to get blocked. Kidney stones or bladder stones can also increase the risk of a ureteral blockage. Other possible causes include blood clots, growths (tumors), extra tissue, or swollen lymph nodes.

Blockages in the tubes that carry urine from the kidneys to the bladder (ureters) can cause infections in the urinary system and harm the kidneys. This damage can sometimes be permanent. In simple terms, if urine can't flow properly, it can lead to infections and potentially serious, lasting kidney problems.

Doctors often find problems with the tubes that carry urine (ureters) during routine pregnancy ultrasounds. These ultrasounds show the developing baby's organs, including the kidneys, ureters, and bladder. A follow-up ultrasound after birth might be done to check the kidneys again.

If a doctor thinks you might have a blocked ureter, they may use several tests to figure out what's going on:

Blood and Urine Tests: Samples of your blood and urine are checked for signs of infection. If your kidneys aren't working correctly, there will be higher levels of a substance called creatinine in your blood and urine.

Ultrasound: A special ultrasound, called a retroperitoneal ultrasound, can show the kidneys and ureters. This ultrasound uses sound waves to create images of the body.

Bladder Catheterization: A thin tube (catheter) is inserted into your bladder. Dye is then injected into the bladder, and X-rays are taken. These X-rays show how well urine flows through the kidneys, ureters, bladder, and urethra, both before and during urination. This helps to see if there are blockages.

Renal Nuclear Scan: A small amount of radioactive material is injected into your arm. A special camera detects this material and creates pictures of your urinary system. This helps doctors see how well your kidneys and the tubes are working.

Cystoscopy: A small, thin tube with a camera and light is put into your urethra (the tube that carries urine out of your body). This lets the doctor see inside your urethra and bladder.

CT Scan (Computed Tomography): A CT scan uses many X-ray pictures taken from different angles to create detailed cross-sectional images of your kidneys, ureters, and bladder. This can show any blockages or problems in these areas.

MRI (Magnetic Resonance Imaging): An MRI uses magnets and radio waves to create detailed images of your internal organs, including the kidneys, ureters, and bladder. This gives another view of the urinary system.

Mayo Clinic Care: Mayo Clinic has a team of experts who can help you with any concerns about ureteral obstruction. They offer various ways to get help.

Treating a blocked ureter (ureteral obstruction) aims to fix the blockage or create a way around it to prevent kidney damage. Sometimes, an infection is also present, and antibiotics are used to treat it.

If a blocked ureter causes severe pain, a quick procedure might be needed to drain the urine and ease the pain. Your doctor (urologist) may recommend one or a combination of these:

• Ureteral stent: A small, hollow tube placed inside the ureter to keep it open.
• Percutaneous nephrostomy: A tube is put through your back to drain the kidney directly.
• Catheter: A tube placed through your urethra to drain urine into a bag. This is helpful if bladder problems are also causing poor kidney drainage.

Your doctor will decide which treatment is best for you. These drainage methods can offer temporary or permanent relief, depending on the cause of the blockage.

Several surgical options can fix a blocked ureter. The best choice depends on your specific situation:

• Endoscopic surgery: A thin, lighted tube is passed through your urethra to the affected part of the ureter. The surgeon makes a small cut to widen the blocked area and inserts a tube (stent) to keep it open. This procedure can be used for both diagnosis and treatment.
• Open surgery: A larger cut is made in your abdomen to remove the blockage and repair the ureter.
• Laparoscopic surgery: Small cuts are made in your skin, and a small tube with a light and camera is used to guide instruments to the blocked area.
• Robot-assisted laparoscopic surgery: This is similar to laparoscopic surgery, but a robot helps the surgeon with the procedure.

The main differences between these surgeries are recovery time and the number of cuts needed. Your doctor will choose the best surgical approach for your situation.