Reviewers: Nikhil Sangle, M.D. (see Reviewers page)
Revised: 26 December 2012, last major update September 2012
Copyright: (c) 2003-2012, PathologyOutlines.com, Inc.
● 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
● Thin cortical rim due to atrophy
● More calyceal dilation if incomplete obstruction, since glomerular filtration is not suppressed
● Initial functional alterations are tubular, cause interstitial inflammatory infiltrate
● Chronic changes are cortical atrophy, diffuse interstitial fibrosis and blunting of calyces
Tubular atrophy, interstitial fibrosis and interstitial inflammation
Grading of obstructive uropathy
End of Kidney non-tumor > Miscellaneous > Obstructive uropathy
Ref Updated: 9/6/12
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