Why Choose Cedars-Sinai Marina del Rey Hospital for Urinary Obstruction Treatment?
The specialized urologists at Cedars-Sinai Marina del Rey Hospital evaluate patients with symptoms of urinary tract obstruction to identify the cause and provide the least invasive solution to the problem. After taking into account the factors regarding your age, overall health, and your preferences, the most viable treatment option is suggested.
Urinary obstruction, also called obstructive uropathy is a condition in which urine cannot flow through the ureters - a pair of tubes that transport urine from the kidneys to the bladder - and out of the body. This happens because of some kind of obstruction that causes backward flow or reflux of urine into the kidneys. This can lead to swelling and damage to either one or both of your kidneys. This problem may occur in both men and women regardless of their age. Moreover, the urinary obstruction may occur in a fetus during its developmental stages.
Urinary obstruction is often the major cause of acute and chronic renal failure. Usually, the signs and symptoms are milder and develop slowly over a period of time. Identification of this problem at an early stage and prompt treatment could help prevent further kidney damage.
Urinary Obstruction - Surgical Procedures Performed at Cedars-Sinai Marina del Rey Hospital
At Cedars-Sinai Marina del Rey Hospital, our surgeons deal with urinary obstruction by getting rid of the obstacle from the ureters that is causing the blockage, for example, abnormal masses. This is the main objective of the surgical treatment of urinary obstruction.
Surgical removal of polyps, tumors, or scar tissues that develop inside or around the ureters is performed to provide a long-term solution to the problem. After this procedure, urine can flow down from the affected ureter into the bladder.
Drugs and Other Treatment Needed for Urinary Obstruction
ureteral stent or
nephrostomy tube »
Intrarenal obstruction »
Ureteral obstruction »
Symptoms of Urinary Obstruction
The signs and symptoms of urinary obstruction vary depending on whether the condition develops suddenly or progressively over a period of time. The common symptoms include pain in the sides and back portion of your body (flank pain), fever, nausea, and vomiting. You may also experience problems while passing urine, which indicates a ureteral blockage. Changes in bladder habits include:
Symptoms of Urinary Obstruction in a Developing Fetus
A sign of urinary obstruction in a fetus is a drop in the level of the amniotic fluid volume. Urine is one of the constituents of the amniotic fluid, and as a fetus with obstruction cannot urinate, the amniotic fluid level decreases leading to complications during birth.
Diagnosis of Urinary Obstruction
Your doctor will be able to diagnose urinary obstruction by using the following methods:
During physical examination, your doctor will perform the following assessments:
- Evaluating the signs of intravascular volume depletion and dehydration such as swollen feet and ankles, hypertension
- A palpable bladder or kidney is a sign of dilated urinary collection system
- Rectal or pelvic examination is done to find out if there is any enlargement of the pelvic organs that could be causing the urinary obstruction
- Examination of the external portion of your urethra to rule out meatal stenosis and phimosis.
Laboratory studies include the following tests:
- Urine tests: Urine tests help in finding the presence of infection, stones or tumor mass. The urine sample is evaluated microscopically for the presence of RBCs, WBCs, and urine pH is also determined.
- Blood tests: Blood tests include complete blood cell count (CBC), which can indicate the presence of anemia and infection. Increased WBC count indicates an infection and a decrease in hemoglobin levels indicate anemia.
- Basic Metabolic Panel: This involves tests to evaluate levels of sodium, potassium, chloride, bicarbonate in the serum, along with blood urea nitrogen (BUN), creatinine, calcium, phosphate, uric acid, magnesium, and albumin. Hyperkalemia with an elevated creatinine and BUN level indicates renal insufficiency.
Imaging studies help in identifying any anatomical flaws and the exact site of the blockage. Imaging studies that may be required to evaluate the cause of urinary obstruction include:
- CT scan (Helical CT): Helical CT scan, without the contrast, is often used as the first test in the radiologic evaluation of the urinary system.
- Magnetic Resonance Imaging Scan (MRI scan): MRI scan is the imaging study of choice to detect urinary obstruction.
- IV pyelography (IVP): It is a procedure, which helps define the extent of the obstruction
- Ultrasonography: Ultrasound examination helps to determine hydronephrosis in the kidneys.
Risk Factors for Urinary Obstruction
The factors that predispose you to the development of urinary obstruction include:
- Family history of urinary obstruction
- Urinary tract or kidney disorders in the past
- Presence of tumor, calculus, or blood clot within the urinary tract
- Ureteral or urethral strictures
- Paralysis of the bladder
- Pressure exerted on the urinary tract from an enlarged prostate gland or an expanding tumor
Causes of Urinary Obstruction
Urinary obstruction may result from several factors such as:
- Tumors that spread into your bladder, kidneys
- Cancer involving the colon, uterus, and cervix
- Trauma caused by fracture in the pelvic bone
- Renal stones that may get entrapped in the ureter
- Formation of blood clots, scar tissues inside or outside the ureters
- Digestive tract disorders
- Nervous system disorders: Malfunctioning of the nerves associated with bladder control
- Use of the medications that treat an overactive bladder
- Prostate gland enlargement
In rare circumstances, the urinary obstruction may occur during pregnancy causing the reflux of urine to the kidneys. This happens because of the fetal weight compressing upon the bladder.
Urinary obstruction can be prevented by treating its underlying causes. Most people often hold back urine for an extended duration. This should be avoided as it causes weakness of the bladder muscles due to overstretching. You should urinate around 4 to 6 times a day to maintain normal functions of your bladder. Retention of urine for prolonged hours may cause deposition of stones, which may lead to urinary obstruction, over a period of time.
For any questions, information or guidance related to urinary obstruction, consult our specialty-trained, skilled urologic surgeons at Cedars-Sinai Marina del Rey Hospital.