Acute Bilateral Obstructive Uropathy

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Overview, Causes, & Risk Factors

Obstructive uropathy occurs when the flow of urine is blocked. The kidneys produce urine in the normal manner but the urine does not drain properly because of the obstruction. Pressure in the urinary tract rises, resulting in hydronephrosis (swelling of the kidneys) and bilateral obstructive uropathy (damage to both kidneys caused by obstruction of urine). Obstructive uropathy may eventually lead to hypertension and/or acute renal failure. Sudden blockage causes acute bilateral obstructive uropathy, while slow, progressive blockage causes chronic bilateral obstructive uropathy.

Acute bilateral obstructive uropathy is usually caused by obstruction of the urethra that occurs suddenly or over a short time. In men, it is most often a result of an enlarged prostate. Other causes in men include prostate cancer, bilateral obstructing kidney stones and bladder cancer. It is much less common in women but can occur as a result of a bladder cystocele, pregnancy and iatrogenic (caused by treatment) injury due to surgery involving the female reproductive organs. Other causes include posterior urethral valves in infant boys, neurogenic bladder, papillary necrosis, coagulated blood, fungus and other rare retroperitoneal processes.

Initially, the bladder reacts to the obstruction through increased irritability. There is a stronger and more frequent urge to urinate, and bladder spasms or incontinence may occur. As urine accumulates, it may lead to stasis of urine and urinary tract infections (see UTI - acute). Urine may back up into the ureters (tubes which carry urine from the kidneys to the bladder) and kidney. Symptoms develop because of urinary retention and/or damage to the bladder, ureters and kidneys.

Acute bilateral obstructive uropathy occurs in about 5 out of 10,000 people.