Acute bilateral obstructive uropathy

Alternative names:

acute urethral obstruction; obstructive uropathy - bilateral - acute; urethral obstruction

Symptoms:

• 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
• urinary frequency/urgency, increased
• need to urinate at night
• frequent strong urge to urinate
• burning or stinging with urination
• feeling of incomplete emptying of the bladder
• flank pain or pain in the sides
  • on both sides
  • began suddenly

• blood in the urine
• high blood pressure (hypertension), recent increase
• urine, abnormal color

Signs and tests:

Examination of the abdomen by touch (palpation) shows enlarged and tender kidneys. Palpation over the bladder shows bladder distention. Placement of a catheter in the bladder may relieve the lack of urine output. Post-void residuals (catheterized measurement of the volume of urine that remains in the bladder after urinating) are repeatedly more than 50 ml. Rectal examination usually shows an enlarged prostate. Blood pressure may be elevated. There may be signs and symptoms of acute renal failure. Fever with infection is common.

• A urinalysis may be abnormal.
• A clean catch urine specimen may show infection within the urinary tract.
• The serum creatinine may increase suddenly, by 2 mg/dL or more over a two-week period.
• The creatinine clearance may be decreased.
• The BUN may increase suddenly.
• A potassium test may be elevated.
• Arterial blood gas and blood chemistries may show metabolic acidosis.

Hydronephrosis may be apparent in any of the following tests:

• IVP
• renal scan
• ultrasound of the kidneys
• abdominal CT scan

This disease may also alter the results of the following tests:

• radionuclide cystogram
• creatinine - urine