Kidney nontumor
Miscellaneous
Obstructive uropathy

Author: Nikhil Sangle, M.D. (see Authors page)

Revised: 26 March 2018, last major update December 2012

Copyright: (c) 2003-2018, PathologyOutlines.com, Inc.

PubMed Search: Obstructive uropathy [title] human

Cite this page: Sangle, N. Obstructive uropathy. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/kidneyobstructive.html. Accessed May 24th, 2018.
Definition / general
  • Obstructive uropathy is structural or functional hindrance of normal urine flow, sometimes leading to renal dysfunction (obstructive nephropathy)
  • Acute obstruction increases susceptibility to infection; chronic obstruction causes hydronephrosis
  • Causes: bladder neck obstruction, congenital (meatal stenosis, anterior / posterior urethral valves [Pediatr Surg Int 2009;25:613], ureteropelvic junction narrowing, urethral strictures, vesicoureteral reflux); cystocoele, inflammation, neurogenic ureter / bladder, pregnancy, prostatic hypertrophy, sloughed papillae or blood clots, stones, tumors, uterine prolapse
  • Symptoms: none if unaffected kidney maintains adequate function; pain due to distention of collecting system or renal capsule; early - nocturia, polyuria; after relief of obstruction, may get massive diuresis with sodium wasting
  • Hydronephrosis: cystic dilation of renal pelvis and calyces associated with progressive atrophy of kidney, due to obstructive uropathy
Gross description
  • Thin cortical rim due to atrophy
  • More calyceal dilation if incomplete obstruction, since glomerular filtration is not suppressed
Gross images

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Various images

Microscopic (histologic) description
  • Initial functional alterations are tubular, cause interstitial inflammatory infiltrate
  • Chronic changes are cortical atrophy, diffuse interstitial fibrosis and blunting of calyces
Microscopic (histologic) images

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Grading of obstructive uropathy