genitourinary disorders
Obstructive Uropathy
Introduction
Obstructive uropathy is structural or functional hindrance of normal urine flow, sometimes leading to renal dysfunction (obstructive nephropathy). Symptoms, less likely in chronic obstruction, may include pain radiating to the T11 to T12 dermatomes and abnormal voiding (eg, difficulty voiding, anuria, nocturia, and/or polyuria). Diagnosis is based on results of bladder catheterization, cystourethroscopy, and imaging (eg, ultrasonography, CT, pyelography), depending on the level of obstruction. Treatment, depending on cause, may require prompt drainage, instrumentation, surgery (eg, endoscopy, lithotripsy), hormonal therapy, or a combination of these modalities. The prevalence of obstructive uropathy, depending on the cause, ranges from 5 in 10,000 to 5 in 1,000. The condition has a bimodal distribution. In childhood, it is due mainly to congenital anomalies of the urinary tract. Incidence then declines until after age 60, when incidence rises, particularly in men because of the increased incidence of Benign Prostatic Hyperplasia (BPH) and 