Ureteral obstruction

Overview

A ureteral obstruction occurs when one or both ureters become blocked. Ureters are the tubes that transport urine from the kidneys to the bladder. When these tubes are obstructed, it inhibits urine flow into and out of the bladder, which can cause pain and increase the risk of infection.

Ureteral obstruction is a common condition caused by a variety of factors such as scar tissue, ureteral stones, tumors, and others. If left untreated, urine can back up and cause kidney injury.

Untreated ureteral obstruction can cause symptoms that may quickly progress from mild to severe. In rare cases, it can lead to kidney failure, sepsis, or even death. However, these severe complications can usually be prevented with prompt treatment.

Symptoms

Symptoms and signs of a ureteral obstruction can vary depending on the location and severity of the blockage, as well as whether it affects one or both kidneys. If the obstruction is caused by a stone, patients may experience severe pain. When the blockage occurs gradually, symptoms may develop slowly over time. Mild symptoms can worsen quickly if left untreated. Common symptoms of a blocked ureter or urinary tract obstruction include:

• Pain, usually in the abdomen, lower back, or sides below the ribcage.
• Changes in the amount of urine output
• Having trouble peeing or emptying the bladder
• Urine containing blood
• Recurring urinary tract infections
• Hypertension
• Fever, nausea, or vomiting
• Urine that has a crimson or hazy appearance
• One or both legs are swollen

If any of the signs and symptoms persist, consult a doctor right away. Symptoms may get worse when left untreated. It may be urgent when there is an intense pain accompanied by nausea, vomiting, fever, or chills. In addition, consultation is necessary for people with intense pain that prevents them from sitting still or finding a comfortable posture, who has blood in their urine, or who have difficulty urinating. It is critical to consult the doctor for a diagnosis and treatment.

Causes

The ureter may get blocked due to several causes. The following are some of the causes of ureteral obstruction:

• Duplicated ureter: Duplicated ureter is a congenital condition in which two ureters develop in the same kidney, either completely or partially. This disorder can lead to urinary backup and kidney damage if one or both ureters fail to function properly.
• Obstruction in the ureteropelvic junction: The Condition of ureteropelvic junction obstruction can be present at birth, or it may develop due to factors such as injury, scarring, or malignancy. The ureteropelvic junction is the area where the ureter and kidney meet, and any obstruction in this area can cause urine to back up into the kidneys. If the ureterovesical junction gets blocked, it can obstruct the flow of urine, leading to kidney enlargement and eventual failure.
• Ureterocele: A ureterocele usually develops in the section of the ureter closest to the bladder, and it can result in kidney damage by obstructing the flow of urine and causing it to back up into the kidney. A ureterocele can form when the ureter is too narrow to permit proper urine flow.
• Retroperitoneal fibrosis:  Fibers can develop due to malignant tumors or as a side effect of certain migraine medications. These fibers can wrap around and obstruct the ureters, leading to urine backup in the kidneys. This condition typically arises when fibrous tissue accumulates behind the abdomen.
• Other causes of ureteral obstruction: Ureteral obstruction can be caused by a variety of factors both intrinsic and extrinsic, such as kidney stones, benign prostatic hyperplasia, blood clots, tumors, swollen lymph nodes, or gastrointestinal problems like Crohn’s disease and diverticulitis.

Chronic enlargement of the ureter wall, commonly caused by tuberculosis or a parasitic illness known as schistosomiasis can also lead to ureteral obstruction. Pregnancy, endometriosis, or uterine prolapse are all possibilities.