Table of Contents
Definition / general | Gross description | Gross images | Microscopic (histologic) descriptionCite this page: Sangle N. Obstructive uropathy. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/kidneyobstructive.html. Accessed December 4th, 2024.
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
Microscopic (histologic) description
- Initial functional alterations are tubular, cause interstitial inflammatory infiltrate
- Chronic changes are cortical atrophy, diffuse interstitial fibrosis and blunting of calyces