Ureteric obstruction

Both genders can develop urinary tract obstruction; however, due to the different anatomical design, women are almost exclusively at risk of developing ureteric obstruction, whereas men can develop both ureteric and urethral obstruction, as well as obstruction due to BPH. The symptoms must be taken seriously, because ureteric obstruction can cause severe health problems over time. If you are experiencing symptoms indicating ureteric obstruction you should contact your doctor.

What are common causes?

The ureters are muscular tubes that transfers the urine formed in the kidneys to the bladder. The ureters can be obstructed due to both benign as well as malignant conditions. The anatomical lesion producing the obstruction is called a stricture.

Benign causes of ureteric obstruction:

  • Retroperitoneal fibrosis
  • Kidney transplant anastomosis
  • Ileal conduit ("Bricker Bladder")
  • Traumatic
  • Radiation (actinic) fibrosis

Malignant causes:

  • Metastatic illness (e.g. colonic, cervical, bladder or prostate cancer)

What are the symptoms?

The most common symptom of ureteric obstruction is constant or intermittent flank and/or lower abdominal pain, although some experience no pain at all. As ureteric obstruction may cause urinary tract infection, any and all symptoms of infection may show, e.g.

  • Fever
  • Malaise
  • Frequent voiding, foul smelling urine, pain when urinating.

How is urinary tract obstruction diagnosed?

An X-ray imaging procedure during which contrast fluid administered intravenously and secreted into the ureters via the kidneys will usually reveal any obstruction of the ureters.

What are the treatment options?

Balloon Dilatation is usually used to dilate the obstructed area as a first line of treatment. If this is not sufficient, a stent may be inserted, either as a JJ-stent (AKA pigtail catheter) or a Memokath™ stent.

A JJ-stent is a plastic tube, shaped like a J in both ends that is inserted in the ureter. Unfortunately, the JJ-stent may cause a lot of discomfort, and it is often necessary to change the stent every 3-4 months.

The Memokath™ on the other hand, may be left in place for much longer - some patients have had the stent in place for years without significant side effects. The Memokath™ stent is easily placed and may just as easily be removed or changed if necessary.