Acute bilateral obstructive uropathy

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Bladder catheterization, female

Bladder catheterization, male

Female urinary tract

Male urinary tract

Urethral obstruction; Acute urethral obstruction; Obstructive uropathy - bilateral - acute

• Decreased urine output (may be less than 10 mL per day)
• Urinary hesitancy
• Abnormal urine flow -- dribbling at the end of urination
• Incontinence
• Decrease in the force of the urinary stream, stream small and weak
• Increased urinary frequency or urgency
• Need to urinate at night
• Frequent strong urge to urinate
• Burning or stinging with urination
• Feeling of incomplete emptying of the bladder
• Sudden flank pain or pain on both sides
• Blood in the urine
• Fever
• Nausea and vomiting
• High blood pressure (hypertension), recent increase
• Urine, abnormal 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. Fever is common with an infection.

• Urinalysis  and a urine culture (clean catch) may show a urinary tract infection.
• Serum creatinine may increase suddenly, by 2 mg/dL or more over a 2-week period.
• 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. Blood BUN may increase suddenly. Creatinine clearance may be decreased.
• A blood potassium test may be elevated.
• 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).
• Arterial blood gas and blood chemistries may show metabolic acidosis.

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

• IVP
• Renal scan
• Ultrasound of the kidneys
• Abdominal CT scan

• Radionuclide cystogram
• Creatinine - urine

Review Date: 05/10/2006
Reviewed By: Neil D. Sherman, MD, Urologist, Essex County, NJ. Review provided by VeriMed Healthcare Network.