Urinary Tract Obstruction(UTO)

Urinary tract obstruction (UTO) is a condition in which the normal flow of urine through the urinary tract is restricted at the renal pelvis, ureters, bladder, or urethra. The condition may be caused by various factors, including kidney stones, tumors, strictures, or congenital anomalies. When urine cannot pass through the obstructions, the pressure within the kidneys rises, and the condition of hydronephrosis develops due to dilated renal pelvis and calyces. This pressure, if not well addressed, puts pressure on the renal parenchyma and may result in kidney dysfunction or even kidney failure. The severity of this condition depends on the degree of obstruction, the location, and the duration of the blockage (Rishor-Olney & Hinson, 2023).

The primary cause of UTO is related to factors that cause an increase in pressure within the urinary system, leading to renal dysfunction. As the urine accumulates behind the obstruction, the renal pelvis dilates, and the kidney tissue becomes at risk for ischemia and fibrosis. If the obstructions are prolonged or severe, then there is the likelihood of developing renal atrophy and loss of renal function. Even though patients with acute obstructive lesions usually present with flank pain, nausea, vomiting, and urinary retention, chronic obstructive lesions may be asymptomatic or may present with recurrent UTIs, hematuria, and decreasing GFR. There are several ways of diagnosing the obstruction, including the use of ultrasound computerized tomography to determine the position of the obstruction, and laboratory diagnosis may include urinalysis or the serum creatinine test (Pérez-Aizpurua et al., 2024).

The management of UTO intends to eliminate blockage and reduce damage to the kidney. In mild cases, patient education, such as drinking more water and monitoring, are some of the ways that can be used to manage the condition. Nevertheless, complicated cases call for invasive operations like ureteral stent placement, percutaneous nephrostomy, and the removal of obstruction. Antibiotics are given where there is an indication of infection and the general aim is to promote free urine passage and maintenance of kidney function. Patients’ compliance with health care professionals is necessary for the management of UTO because the patient needs to know about the condition and care that they require. Effective communication in renal or urologic conditions involves clear patient education, active listening, addressing concerns, and fostering trust. This approach helps patients understand their condition and treatment options and encourages informed decision-making and adherence. Also, educating patients on the dangers of untreated UTO and easing their concerns enhances their confidence and overall well-being (McCance & Huether, 2019).

References

McCance, K. L., & Huether, S. E. (2019). Pathophysiology: The biologic basis for disease in adults and children (8th ed.). Elsevier.

Pérez-Aizpurua, X., Benavente, R. C., Serrano, G. B., Peral, J. M. A., Mañas, B. G., Jaumot, J. T. I., De Castroviejo Blanco, J. R., Ospina, F. O., & Gonzalez-Enguita, C. (2024). Obstructive uropathy: Overview of the pathogenesis, etiology and management of a prevalent cause of acute kidney injury. World Journal of Nephrology, 13(2). https://doi.org/10.5527/wjn.v13.i2.93322

Rishor-Olney, C. R., & Hinson, M. R. (2023, July 22). Obstructive uropathy. StatPearls – NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK558921/

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