Is your urethra blocked? Let's learn everything about Ureteral Obstruction in a simple way!

Have you ever had a severe backache, either below your ribs or on either side of your back? Or have you ever felt a pain when you urinate, like you can't pass urine? Sometimes these things can be signs of a serious problem inside your body, even though we don't pay much attention to them. Today we are going to talk about a condition that you may suspect at times like these, but many people are not aware of. That is Ureteral Obstruction, or `(Ureteral Obstruction)`.

Simply put, what is Ureteral Obstruction?

Okay, to understand this, let's first take a look at how this system in our body works. We have two kidneys in our body, right? The main function of these two kidneys is to filter the blood, separate the unnecessary waste products from it, and make urine. It's like a water filter.

The urine that is formed in this way is carried from the kidneys to the bladder (the organ that we use to tell when we are full of urine). These two tubes are called ``Ureters''. There is one for each kidney. The urine that collects in the bladder is then passed out of the body when we urinate.

Now imagine, what happens if this tube (Ureter) that carries urine from the kidney to the bladder gets blocked or obstructed for some reason? That's what we call Ureteral Obstruction. It's like when a piece of dirt gets stuck inside a water pipe, the water stops flowing.

When the flow of urine stops in this way, urine starts to back up and collect inside the kidney. This can cause the kidney to swell and become damaged. Also, the chance of infection is very high due to urine that stays in one place. If this is not treated quickly, it can lead to serious conditions such as kidney failure or severe infection (sepsis). But don't worry, this condition can be diagnosed and treated early.

Who is most likely to develop this condition?

In fact, this condition can occur at any age, in anyone. Even young children can develop it due to certain congenital causes.

However, this condition is more common in men over the age of 60. The main reason for this is that the prostate gland enlarges as we age. This gland is located below the bladder. So when it enlarges, it is more likely to squeeze and block the urethra.

What are the symptoms of this? How do we recognize it?

The symptoms of a urinary tract obstruction can vary from person to person. They also vary depending on the cause of the obstruction and the speed at which it occurs. For example, if a kidney stone suddenly becomes lodged in the urethra, the pain is severe. However, if the urethra becomes blocked gradually due to another cause, the symptoms develop gradually.

Here are some symptoms you should be aware of:

What causes urinary tract obstruction like this?

There are many reasons that can affect this. Some are internal to the body, while others are caused by external pressure.

Obstructions within the body:

• Ureteral Stones: This is the most common cause. Stones that form in the kidneys travel with the urine and get stuck inside this thin tube called the ureter.
• Benign Prostatic Hyperplasia (BPH): As we discussed earlier, in older men, the prostate gland can enlarge and press on the urethra.
• Scar Tissue: Scar tissue can form inside the urethra due to previous surgery, infection, or an accident, blocking the flow of urine. Sometimes, these can be present at birth.
• Problems that come from birth:
• `Ureteropelvic Junction Obstruction`: This is a congenital blockage at the junction of the kidney and ureter.
• `Ureterocele`: A balloon-like bulge that blocks the urethra where it connects to the bladder.
• Ectopic Ureter: The ureter is attached to the wrong place in the bladder.

Obstructions caused by pressure from outside the body:

• Tumors or Cysts: Tumors or cysts: Tumors or cysts that develop in the abdomen or pelvic area, either cancerous or non-cancerous, can protrude from the urethra and block it. (Ex: Cervical cancer, Colon cancer)
• Digestive system diseases: Conditions like Crohn's disease and diverticulitis can cause the intestines to swell, and that swelling can cause pressure on the urethra.
• Reasons specific to women:
• Pregnancy: As the uterus enlarges due to the growing baby, the urethra may become compressed.
• Endometriosis: Tissue that lines the inside of the uterus grows outside the uterus, causing it to grow around the urethra and cause obstruction.
• Uterine Prolapse: The uterus may descend from its normal position, causing pressure on the bladder and urethra.

How does a doctor accurately diagnose this condition?

When you go to see a doctor with your symptoms, he will first ask you questions, examine you, and then order several tests to confirm the diagnosis.

• Blood tests and Urinalysis: These can check how your kidneys are working (especially your creatinine level) and whether there is an infection or blood in your urine.
• Ultrasound Scan: This is a very simple, painless test. It can clearly see if the kidneys are swollen or blocked.
• CT Scan: This can produce clearer, three-dimensional images of the inside of the body. This can help determine exactly where the blockage is and what is causing it (e.g., a stone or a lump).
• Bladder Scan: This checks whether your bladder empties completely after you urinate, or whether there is any urine left.

How is it treated?

The treatment depends on the cause of your blockage, the extent of the blockage, and your overall health. There are two main steps in treatment.

1. First step: Taking out the urine (removing the blockage)

The first thing to do is to remove the accumulated urine from the body to stop the damage to the kidneys. There are several ways to do this.

• Ureteral Stent: A thin, flexible tube (stent) is inserted through the bladder and down the ureter to the kidney. This tube opens up the blocked tube and allows urine to flow more easily.
• Nephrostomy Tube: In some cases, a small tube is inserted through the skin directly into the kidney, through which urine is collected into a bag.
• Catheterization: If the blockage is near the bladder, a catheter is inserted through the urethra into the bladder to drain the urine.

2. Step Two: Treat the Cause of the Blockage

Once urine flow is restored, the doctor will begin treating the underlying cause of the blockage.

• Medications: For conditions such as benign prostatic hyperplasia (BPH), medications can be given to shrink the gland or relax the muscles around it.
• Surgery: In most cases, the permanent solution is surgery. But don't be afraid to say "surgery." With today's technology, most of the time, minimally invasive surgeries are performed using small incisions.
• If it is a urinary stone, it can be crushed using shockwave lithotripsy or removed using methods such as endoscopy by inserting a thin instrument with a camera.
• If there is a lump, scar, or congenital blockage, surgery will remove that part and realign the tube.

Your doctor will explain to you in detail which treatment method is most suitable for you.

Is there anything we can do to prevent this situation?

Some causes, especially congenital problems, cannot be prevented. However, there are things we can do to reduce our risk. These things can help prevent the most common cause, especially urinary stones.

• Drink plenty of water: It is very important to drink at least 2-3 liters of water a day. This dilutes the urine and reduces the risk of stone formation.
• Maintain a healthy weight: It is important to control your body weight.
• Reduce salt intake: Reduce the amount of salt you add to your food. Canned foods, processed meats, and sauces are high in salt.
• Get enough calcium: Some people think that reducing calcium intake will reduce the risk of stone formation. But that's not true. Get the required amount of calcium (about 1000-1200 milligrams) from food each day.

Ureteral Obstruction, Kidney Disease, Ureteral Obstruction, Urinary Stones, Back Pain, Urinary Tract Infection, Prostate