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Ureteral Obstruction

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  • Ureteral Obstruction

     Pathophysiology

    Ureteral Obstruction is structural or functional hindrance of normal urine flow, sometimes leading to renal dysfunction (obstructive nephropathy). Ureteral obstruction can be classified as intraluminal or extraluminal. Intraluminal causes include kidney stones, blood clots and scarring; these conditions usually cause unilateral obstruction and Extraluminal causes include several conditions related to enlarged masses that place pressure on the ureter and create obstructions.

  • Ureteral Obstruction

     Disease statistics

    Unilateral or bilateral ureteral obstruction was found in 66 patients (54.1%). High stage (T3-T4) and grade (III-IV) tumors were correlated with ureteral obstruction in 89.4% and 83.3% respectively compared to 67.9% and 66.1%, respectively, among patients with normal upper tracts (P < 0.001); 10.6% of the patients with ureteral obstruction had low stage disease, and all of them proved to have involvement of the ureteral orifices on the affected side.

  • Ureteral Obstruction

     Disease treatment

    Stents or drains placed in the ureter or in a part of the kidney called the renal pelvis may provide short-term relief of symptoms. Long-term relief from obstructive uropathy requires surgery. A Foley catheter, placed through the urethra into the bladder, may also be helpful.

  • Ureteral Obstruction

     Major research

    Studies had shown that unilateral ureteral obstruction is accompanied by complex changes in renovascular response and function during the first 24 hours. The increase in sensitivity to angiotensin II conduces to progressive vasoconstriction in cortex and medulla after 2 hours of obstruction and the hemodynamic changes seen after unilateral ureteral obstruction, especially with enzyme conversion inhibitors of angiotensin, and the angiotensin II AT1 receptors.

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