Session 12: Urinary Tract Obstruction

Question 1

Classification of causes of ureteric obstruction.

Answer 1

Intraluminal

Intramural

Extraluminal

Question 2

Intraluminal cuases

Answer 2

Clots

Calculi

Question 3

Intramural causes

Answer 3

TCC e.g.

Question 4

Extraluminal causes

Answer 4

Retroperitoneal malignancy such as lymph node metastases, breast, gynae, prostate or other malignancies.

Direct obstruction by a tumour like in bladder cancer obstruction the vesicoureteric junciton or locally advanced prostate cancer.

Retroperitoneal fibrosis

Question 5

Clinical presentation of acute ureteric obstruction.

Answer 5

Renal colic where back pain radiates to groin and there may be associated vomiting.

Usually unilateral and can cause pyonephrosis

Question 6

What can obstructive uropathy cause?

Answer 6

Renal impairment

Post-renal AKI

Hyperkalaemia

Question 7

What is pyonephrosis?

Answer 7

Infected, obstructed kidney.

This is a medical emergency.

Question 8

Complications of pyonephrosis

Answer 8

Permanent loss of renal function

Death from sepsis

Question 9

Treatment of pyonephrosis

Answer 9

Sepsis 6

Question 10

Diagnosis of upper tract obstruction

Answer 10

CT + USS

Also Diuretic renography (MAG3) which is an assessment of renal function.