Their voiding cystograms, video-recorded cystoscopy and presenting signs were reviewed. RESULTS: Of the 39 boys assessed, a voiding cystogram and presenting signs were available in 36. [ncbi.nlm.nih.gov]

• Surgical Procedure

  Ureterolysis: A surgical procedure that exposes the ureter and frees it from abnormal fibrous or scar tissues. Pyeloplasty: A surgical procedure that involves repairing any damage to the ureter and inserting a hollow tube (stent) to keep it open. [humanitas.net]

  Surgical procedures to resolve urethral obstruction were performed transvaginally and the specific techniques used were based on the type of sling material, urethral erosion and concomitant stress incontinence or other urethral pathology. [ncbi.nlm.nih.gov]

  Surgical procedures There are a number of surgical procedures used to correct ureteral obstructions. The type of procedure depends on your situation. [mayoclinic.org]

  Depending on the severity of the PUV, it can be treated with various surgical interventions. Endoscopic incision of valves is the most common surgical procedure. [choc.org]

• Asymptomatic

  One patient became completely asymptomatic. The other had subjective and urodynamic resolution of her obstructive symptoms, but persistent detrusor instability. [ncbi.nlm.nih.gov]

  Patients range from having oliguria/anuria to only having asymptomatic hydronephrosis that is incidentally identified through imaging or elevated creatinine levels. [amboss.com]

  Asymptomatic bacteriuria in diabetic women. Diabetes Care 23:722–723, 2000. Table 1. [ekjm.org]

  This phenomenon was observed in most of our patients (Table 1) and we agree that the otherwise asymptomatic patient who presents with AKI and hyperkalemic hyperchloremic metabolic acidosis should undergo evaluation for UTO. [hindawi.com]

• Abdominal Pain

  A four-year-old neutered male domestic short hair presented with dysuria, stranguria and abdominal pain. Clinical examination revealed a large bladder, but all other organ systems functioning within normal limits. [tandfonline.com]

  Safer Care Victoria Published Date 06 Jun 2019 Last Updated 19 Jul 2019 Download our fact sheet below to provide your patients with easy to follow guidance on abdominal pain. This fact sheet has the #... Read more... [bettersafercare.vic.gov.au]

  pain Continuous feeling of a full bladder Frequent urination Pain during urination (dysuria) Problems starting urination (urinary hesitancy) Slow, uneven urine flow, at times being unable to urinate Straining to urinate Urinary tract infection Waking [medlineplus.gov]

  […] to thrive Recurrent pyelonephritis Children and adults Flank pain or upper abdominal pain that may be triggered or worsened during states of increased diuresis (e.g., after caffeine or alcohol consumption). [amboss.com]

• Suprapubic Pain

  He did not have dysuria, haematuria or suprapubic pain. On palpation, an oval solid mass was detected at the level of the glans penis. An impacted urethral calculus was suspected. [nature.com]

  (i.e., fever and chills → suspicious for urosepsis) Urinary retention Suprapubic pain and mild distention of the lower quadrants Palpable bladder Chronic obstruction Often asymptomatic Hypertension Bilateral UTO/UTO in a solitary kidney (see chronic [amboss.com]

  Usually severe suprapubic pain (but not if superimposed on chronic retention or underlying neuropathy). Look for evidence of a distended bladder - eg, abdominal distention, suprapubic dullness on percussion. [patient.info]

• Hypertension

  Signs and symptoms might include: Pain Changes in the amount of urine produced Difficulty urinating Blood in the urine Repeated urinary tract infections High blood pressure (hypertension) When to see a doctor Make an appointment with your doctor if you [mayoclinic.org]

  Diagnosis Physical exam The physical examination should include the following: Evaluation for signs of dehydration and intravascular volume depletion; peripheral edema, hypertension, and signs of congestive heart failure from fluid overload may be observed [emedicine.medscape.com]

  Endometriosis Presenting as an Intraluminal Colon Mass Causing Chronic Ureteral Obstruction A 40-year-old woman with a past medical history of hypertension and severe endometriosis presented to the ED with a serum creatinine of 17 mg/dL and BUN of 86 [hindawi.com]

  […] vomiting Oliguria or anuria (rare) Clinical signs of inflammation (i.e., fever and chills → suspicious for urosepsis) Urinary retention Suprapubic pain and mild distention of the lower quadrants Palpable bladder Chronic obstruction Often asymptomatic Hypertension [amboss.com]

• Irritability

  All patients had either obstructive or irritative findings or retention and 10 of 14 had an elevated postvoid residual volume. The average follow-up was 12 months. [ncbi.nlm.nih.gov]

• Flank Pain

  Grotegut, M.D. 1 Citing Article A 19-year-old primigravida presented with fever and right-flank pain at 22 weeks of gestation. She was found to have pyelonephritis and underwent renal ultrasonography. [nejm.org]

  First is a patient with flank pain presenting in emergency department. The classic clinical presentation of a young man writhing in pain is usually distinctive. However, atypical presentations are not uncommon. [intechopen.com]

  The presentation of UTO depends on the site, degree, and duration of obstruction and may be acute (flank pain, urinary retention, etc.) or chronic. [amboss.com]

  These obstructions present acutely, leading to severe renal colic with flank pain, hematuria, nausea, vomiting, and fever. [emedicine.medscape.com]

  Symptoms of a blocked ureter or urinary tract obstruction include: Pain in your abdomen, lower back or sides below your ribs (flank pain). Fever, nausea or vomiting. Difficulty urinating or emptying your bladder. Frequent urination. [my.clevelandclinic.org]

• Bladder Neck Obstruction

  The index cannot differentiate the site of obstruction as noted by the similar scores among men with BPH from those with bladder neck obstruction and urethral strictures. [ncbi.nlm.nih.gov]

  Vesicoureteral reflux in the absence of urinary tract infection or bladder neck obstruction often resolves with age. [accessmedicine.mhmedical.com]

  Bladder neck obstruction in women: a real entity. J Urol 1984; 132: 294-298 11） Nitti VW, Tu LM, Gitlin J. Diagnosing bladder outlet obstruction in women. J Urol 1999; 161: 1535-1540 12） Groutz A, Blaivas JG, Chaikin DC. [minds.jcqhc.or.jp]

  For the obstructed bladder neck case, the inlet diameter was reduced to 0.5 mm. All other factors were held constant. [jyi.org]

• Urinary Hesitancy

  hesitancy) Slow, uneven urine flow, at times being unable to urinate Straining to urinate Urinary tract infection Waking up at night to urinate (nocturia) Your health care provider will ask about your symptoms and medical history. [medlineplus.gov]

  hesitancy) Slow, uneven urine flow, at times being unable to urinate Straining to urinate Urinary tract infection Waking up at night to urinate (nocturia) Exams and Tests Your health care provider will ask about your symptoms and medical history. [ufhealth.org]

  Chronic lower tract obstruction Usual signs and symptoms include: Urinary hesitancy. Narrow and weak urine stream. Dribbling at end of micturition. Feeling of incompletely emptied bladder. [patient.info]

• Anuria

  Complete obstruction causes complete anuria. Investigation Renal function will only be severely altered if obstruction affects both kidneys (or a single functioning kidney). Rectal/vaginal examination may reveal enlarged prostate or pelvic tumour. [edrep.org]

  Patients range from having oliguria/anuria to only having asymptomatic hydronephrosis that is incidentally identified through imaging or elevated creatinine levels. [amboss.com]

  Anuria suggests bilateral complete obstruction. Chronic upper tract obstruction Presents with flank or abdominal pain and/or chronic kidney disease. Polyuria may be a feature. [patient.info]

• Renal Injury

  Early diagnosis of UTO is important since most cases can be corrected and delay in therapy can lead to irreversible renal injury. The degree of azotemia at time of presentation does not reflect the extent of kidney injury and subsequent prognosis. [hindawi.com]

  Inflammatory mediators and growth factors in obstructive renal injury. J Surg Res. 2004 Jun 15. 119(2):149-59. [Medline]. Moudouni SM, Tligui M, Doublet JD, et al. [emedicine.medscape.com]

In addition, children with incontinence or urinary tract infection need a workup because they may also have some type of urinary tract obstruction. [emedicine.medscape.com]

Abstract Voiding dysfunction after surgical treatment of stress incontinence may occur as a result of urethral obstruction secondary to hyperelevation of the bladder neck. [ncbi.nlm.nih.gov]

What are the treatment options? The first treatment option is usually a small operation, during which the stricture is cut open with a small knife, operated through the same cystoscope used for visual diagnosis of the stricture. [pnnmedical.com]

Treatment options for urethral obstruction typically includes surgery or stent placement. [humanitas.net]

Fetal urinary electrolyte and beta2-microglobulin concentrations at 14 weeks' gestation indicated a poor renal prognosis. The pregnancy was therefore terminated. [ncbi.nlm.nih.gov]

Prognosis Prognosis depends on the degree of dilation of the urinary tract and the degree of renal functional impairment. Outcome is typically good in cases with normal amniotic fluid volume. [orpha.net]

Once the diagnosis of LUTO is established, the prognosis for survival is then assessed. The baby’s outcomes have been correlated to the kidney function as assessed prior to treatment. There are two methods to determine the prognosis before surgery. [fetalhealthfoundation.org]

The prognosis is directly proportional to the renal function. [jamanetwork.com]

In children, infection is less common an etiology. [emedicine.medscape.com]

The etiology is unclear and the pathogenesis a subject of continuing debate. Clinical and pathologic experience with seven cases of prune-belly syndrome is reviewed. [ncbi.nlm.nih.gov]

In cases of siblings with Prune Belly Syndrome and mosaicism, a genetic etiology has been suggested but the majority of cases are of a sporadic nature. Diagnostic methods Diagnosis is usually antenatal. [orpha.net]

References:[7][16][17][18][19][20][21][22][23][24][3][25] Complications Hydronephrosis Definition: dilation of the renal pelvis and calyces Etiology Urinary tract obstruction (see “Etiology” above) Vesicoureteral reflux Clinical features May be asymptomatic [amboss.com]

This can be done by either catheterization or surgical intervention depending on the etiology of the obstruction 2. On imaging consider: neurogenic bladder posterior urethral valves [radiopaedia.org]

Greenland S: Modeling and variable selection in epidemiologic analysis. Am J Publ Health 1989;79:340–349. Williams DI, Whitaker RH, Barrat TM, Keeton JE: Urethral valves. Br J Urol 1973;45:200–210. [karger.com]

Summary Epidemiology Annual incidence has been estimated between 1/35,000 and 1/50,000 births and 95% of cases occur in males. [orpha.net]

: Epidemiology of urinary symptoms in the geriatric population. Urol. Clin. North Am., 23(1): 1–10, 1996. Google Scholar | Medline 2. Smith, R., Osterweil, D., Ouslander, J.G. : Perioperative care in the elderly urological patient. Urol. Clin. [journals.sagepub.com]

Trinchieri A: Epidemiology of urolithiasis: an update. Clin Cases Miner Bone Metab. 2008, 5 (2): 101-106. 2. Ahmed A, Saeed NM: Experience with the management of urethral stones presenting with urinary retention at Gusau. [bmcurol.biomedcentral.com]

Epidemiology Age Urinary tract obstruction occurs most commonly in the young and the old: In older men, this is a relatively common condition due to prostatic enlargement: Incidence of lower urinary tract symptoms (LUTs)/BPH averages 15 per 1,000 man-years [patient.info]

The pathophysiology, diagnosis and treatment of this iatrogenic type of female urethral obstruction are discussed. [ncbi.nlm.nih.gov]

Pathophysiology Normal urine production in an adult is about 1.5-2 L/day. [emedicine.medscape.com]

Urinary tract infections in men: epidemiology, pathophysiology, diagnosis, and treatment. Ann Intern Med 110:138–150, 1989. 8. Wood CA, Abrutyn E. Urinary tract infection in older adults. Clin Geriatr Med 14:267–283, 1998. 9. Nicolle LE. [ekjm.org]

It will not prevent the abdominal wall deformity of the prune belly syndrome. The evidence suggests that to allow maximum time for lung development and to prevent increasing renal dysplasia, drainage should be performed before 18 weeks of gestation. [ncbi.nlm.nih.gov]

How can I help prevent urinary obstruction? Some causes of urinary obstruction cannot be prevented. You may be able to help prevent kidney stones by drinking plenty of water to keep your urine dilute. Written by Tom Richards, MD. [kpjampang.com]