Chronic bilateral obstructive uropathy

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Bladder catheterization, female

Bladder catheterization, male

Obstructive uropathy - bilateral - chronic; Kidney failure - chronic blockage

Symptoms depend on the time course of the obstruction and where in the urinary tract the obstruction occurs.

Some of the most common symptoms of chronic obstructive uropathy include:

• Stronger and more frequent urge to urinate
• Difficulty initiating the flow of urine (urinary hesitancy)
• Dribbling of urine, incontinence
• Decreased urine output
• Decrease in the force of the urinary stream
• Increased need to urinate at night
• Burning or stinging with urination
• Feeling of incomplete emptying of the bladder
• Alternating times of increased urine output and decreased urine output
• Fever and chills (if there is also urinary infection)

• Nail problems
• High blood pressure
• Abnormal urine color

A physical exam may show swollen or tender kidneys. The bladder may be large and full. A rectal examination may reveal an enlarged prostate. Signs and symptoms of chronic renal failure may be present. Blood pressure may be high.

• A urinalysis and a urine culture (clean catch) may show a urinary tract infection.
• A CBC may show an increased white blood cell count  
• A basic metabolic panel will reveal patient's current kidney function as well as electrolyte balance, which may be abnormal.
• A bladder scan (ultrasound) may show a large amount of urine in the bladder after urinating (more than 50 mL).
• Uroflowmetry may reveal decreased urinary flow due to a swollen prostate (BPH).

The following tests may show hydronephrosis (swelling of kidneys):

• Abdominal ultrasound
• CT scan of abdomen and pelvis
• Renal scan

Review Date: 05/03/2006
Reviewed By: Neil D. Sherman, MD, Urologist, Essex County, NJ. Review provided by VeriMed Healthcare Network.