Obstructive Uropathy: Causes, Treatment, and Analysis of Complications
https://doi.org/10.35401/2541-9897-2025-10-2-135-142
Abstract
The objective of this article is to provide a comprehensive analysis of urinary tract obstruction—one of the most common emergency conditions. We discuss modern diagnostic methods, surgical methods, and possible complications during treatment.
The article highlights modern endoscopic drainage techniques for acute and chronic urinary tract obstruction and compares various treatment methods and their effectiveness, depending on the chosen approach.
The literature review covers current research on the prevalence of obstructive uropathy in the population, clinical manifestations, and the most common causes of supravesical and/or infravesical obstruction.
About the Authors
E. S. Gazimiev
Scientific Research Institute – Ochapovsky Regional Clinical Hospital No. 1; Kuban State Medical University
Russian Federation
Russian Federation
Emilkhan S. Gazimiev - Postgraduate Student, Urology Department, Kuban State Medical University; Urologist, Urology Unit No. 1, Scientific Research Institute – Ochapovsky Regional Clinical Hospital No. 1.
ulitsa 1 Maya 167, Krasnodar, 350086
V. L. Medvedev
Scientific Research Institute – Ochapovsky Regional Clinical Hospital No. 1; Kuban State Medical University
Russian Federation
Russian Federation
Vladimir L. Medvedev - Dr. Sci. (Med.), Professor, Head of the Urology Department, Kuban State Medical University; Deputy Chief Physician for Urology, Head of the Regional Uronephrology Center, Scientific Research Institute – Ochapovsky Regional Clinical Hospital No. 1.
Krasnodar
G. D. Dmitrenko
Scientific Research Institute – Ochapovsky Regional Clinical Hospital No. 1; Kuban State Medical University
Russian Federation
Russian Federation
George D. Dmitrenko - Cand. Sci. (Med.), Associate Professor at the Urology Department, Kuban State Medical University; Head of the Urology Unit No. 1, Scientific Research Institute – Ochapovsky Regional Clinical Hospital No. 1.
Krasnodar
G. A. Palaguta
Scientific Research Institute – Ochapovsky Regional Clinical Hospital No. 1
Russian Federation
Russian Federation
George A. Palaguta - Urologist, Urology Unit No. 1, Scientific Research Institute – Ochapovsky Regional Clinical Hospital No. 1.
Krasnodar
A. A. Vitaev
Scientific Research Institute – Ochapovsky Regional Clinical Hospital No. 1; Kuban State Medical University
Russian Federation
Russian Federation
Artem A. Vitaev - Assistant Professor at the Urology Department, Kuban State Medical University; Urologist, Urology Unit No. 1, Scientific Research Institute – Ochapovsky Regional Clinical Hospital No. 1.
Krasnodar
V. V. Sergeev
Regional Clinical Hospital No. 2
Russian Federation
Russian Federation
Vladimir V. Sergeev - Cand. Sci. (Med.), Head of the Urology Unit No. 1, Regional Clinical Hospital No. 2.
Krasnodar
References
1. Pérez-Aizpurua X, Cabello Benavente R, Bueno Serrano G, et al. Obstructive uropathy: overview of the pathogenesis, etiol- ogy and management of a prevalent cause of acute kidney injury. World J Nephrol. 2024;13(2):93322. PMID: 38983763. PMCID: PMC11229834. https://doi.org/10.5527/wjn.v13.i2.93322
2. Yaxley J, Yaxley W. Obstructive uropathy – acute and chronic medical management. World J Nephrol. 2023;12(1):1–9. PMID: 36704657. PMCID: PMC9846865. https://doi.org/10.5527/wjn.v12.i1.1
3. Hill AJ, Basourakos SP, Lewicki P, et al. Incidence of kidney stones in the United States: the continuous National Health and Nutrition Examination Survey. J Urol. 2022;207(4):851–856. PMID: 34854755. https://doi.org/10.1097/JU.0000000000002331
4. Stamatelou K, Goldfarb DS. Epidemiology of kidney stones. Healthcare (Basel). 2023;11(3):424. PMID: 36766999. PMCID: PMC9914194. https://doi.org/10.3390/healthcare11030424
5. Patti L, Leslie SW. Acute renal colic. In: StatPearls. Stat-Pearls Publishing; 2024. PMID: 28613743.
6. Tatenuma T, Tsutsumi S, Yasui M, Noguchi G, Umemoto S, Kishida T. Outcome of palliative urinary diversion and observation for malignant extrinsic ureteral obstruction. J Palliat Med. 2020;23(2):254–258. PMID: 31834827. https://doi.org/10.1089/jpm.2019.0038
7. Gadelkareem RA,AbdelraoufAM, El-TaherAM,AhmedAI. Acute kidney injury due to bilateral malignant ureteral obstruction: is there an optimal mode of drainage?. World J Nephrol. 2022;11(6):146–163. PMID: 36530794. PMCID: PMC9752243. https://doi.org/10.5527/wjn.v11.i6.146
8. Rouprêt M, Seisen T, Birtle AJ, et al. European Association of Urology guidelines on upper urinary tract urothelial carcinoma: 2023 update. Eur Urol. 2023;84(1):49–64. PMID: 36967359. https://doi.org/10.1016/j.eururo.2023.03.013
9. El-Alali E, Moreno C, Al Jaber E. Thinking Beyond acute kidney injury. Case Rep Nephrol Dial. 2022;12(1):16–21. PMID: 35433843. PMCID: PMC8958615. https://doi.org/10.1159/000522312
10. Feliciangeli V, Noce A, Montalto G, Germani S, Miano R, Asimakopoulos AD. Non-dilated obstructive nephropathy. Clin Kidney J. 2024;17(10):sfae249. PMID: 39391590. PMCID: PMC11465005. https://doi.org/10.1093/ckj/sfae249
11. Shahzad MA, Baxi PV, Rodby RA. The challenges of diagnosing nondilated obstructive uropathy: a case report. Can J Kidney Health Dis. 2022;9:20543581221086683. PMID: 35356536. PMCID: PMC8958704. https://doi.org/10.1177/20543581221086683
12. Thotakura R, Anjum F. Hydronephrosis and hydroureter. In: StatPearls. StatPearls Publishing; 2023. PMID: 33085364.
13. Hosny M, Chan K, Ibrahim M, Sharma V, Vasdev N. The management of symptomatic hydronephrosis in pregnancy. Cureus. 2024;16(1):e52146. PMID: 38222991. PMCID: PMC10784716. https://doi.org/10.7759/cureus.52146
14. Khalabazyane B, David R, Rashid R, Philips J. Navigating the complexities of symptomatic hydronephrosis in pregnancy. Cureus. 2024;16(5):e61240. PMID: 38939245. PMCID: PMC11210578. https://doi.org/10.7759/cureus.61240
15. Infante Hernández S, Gómez Rivas J, Moreno Sierra J. Benign prostatic hyperplasia. Med Clin (Barc). 2024;163(8):407–414. (In English, Spanish). PMID: 39013719. https://doi.org/10.1016/j.medcli.2024.04.014
16. Cornford P, van den Bergh RCN, Briers E, et al. EAUEANM-ESTRO-ESUR-ISUP-SIOG guidelines on prostate cancer-2024 update. Part I: screening, diagnosis, and local treatment with curative intent. Eur Urol. 2024;86(2):148–163. PMID: 38614820. https://doi.org/10.1016/j.eururo.2024.03.027
17. Molitoris BA. Low-flow acute kidney injury: the pathophysiology of prerenal azotemia, abdominal compartment syndrome, and obstructive uropathy. Clin J Am Soc Nephrol. 2022;17(7):1039–1049. PMID: 35584927. PMCID: PMC9269622. https://doi.org/10.2215/CJN.15341121
18. Rishor-Olney CR, Hinson MR. Obstructive uropathy. In: StatPearls. StatPearls Publishing; 2023. PMID: 32644347.
19. Song L, Maalouf NM. Nephrolithiasis. In: Feingold KR, Ahmed SF, Anawalt B, et al, eds. Endotext. MDText.com, Inc.; 2020. PMID: 25905296.
20. Abi Tayeh G, Safa A, Sarkis J, et al. Determinants of pyelonephritis onset in patients with obstructive urolithiasis. Urologia. 2022;89(1):100–103. PMID: 34338097. https://doi.org/10.1177/03915603211035244
21. Glazer K, Brea IJ, Leslie SW, Vaitla P. Ureterolithiasis. In: StatPearls. StatPearls Publishing; 2024. PMID: 32809509.
22. Gnanapragasam VJ, Greenberg D, Burnet N. Urinary symptoms and prostate cancer-the misconception that may be preventing earlier presentation and better survival outcomes. BMC Med. 2022;20(1):264. PMID: 35922801. PMCID: PMC9351095. https://doi.org/10.1186/s12916-022-02453-7
23. Revzin MV, Srivastava B, Pellerito JS. Ultrasound of the upper urinary tract. Radiol Clin North Am. 2025;63(1):57–82. PMID: 39510663. https://doi.org/10.1016/j.rcl.2024.09.002
24. Orso D, Peric D, Di Gioia CC, et al. Renal and genitourinary ultrasound evaluation in emergency and critical care: an overview. Healthcare (Basel). 2024;12(13):1356. PMID: 38998890. PMCID: PMC11241743. https://doi.org/10.3390/healthcare12131356
25. Jury D, Shaw AD. Utility of bedside ultrasound derived hepatic and renal parenchymal flow patterns to guide management of acute kidney injury. Curr Opin Crit Care. 2021;27(6):587–592. PMID: 34636777. https://doi.org/10.1097/MCC.0000000000000899
26. Fraenkel Y, Bogot NR, Kuint RC, Ben-Shalom E, Benjaminov O, BnayaA. Post-contrast acute kidney injury in the super-elder patients: a CT-scan perspective. Jpn J Radiol. 2025;43(2):247–254. PMID: 39264543. https://doi.org/10.1007/s11604-024-01656-7
27. Doty E, DiGiacomo S, Gunn B, Westafer L, Schoenfeld E. What are the clinical effects of the different emergency department imaging options for suspected renal colic? A scoping review. J Am Coll Emerg Physicians Open. 2021;2(3):e12446. PMID: 34179874. PMCID: PMC8208654. https://doi.org/10.1002/emp2.12446
28. Wang Y, Wang B, Qin J, et al. Use of multiparametric MRI to noninvasively assess iodinated contrast-induced acute kidney injury. Magn Reson Imaging. 2024;114:110248. PMID: 39357626. https://doi.org/10.1016/j.mri.2024.110248
29. Shahbaz H, Rout P, Gupta M. Creatinine clearance. In: StatPearls. StatPearls Publishing; 2024. PMID: 31334948.
30. Rai A, Hsieh A, Smith A. Contemporary diagnosis and management of pelvi-ureteric junction obstruction. BJU Int. 2022;130(3):285–290. PMID: 35044033. https://doi.org/10.1111/bju.15689
31. Weltings S, Schout BMA, Roshani H, Kamphuis GM, Pelger RCM. Lessons from literature: nephrostomy versus Double J ureteral catheterization in patients with obstructive urolithiasis- which method is superior?. J Endourol. 2019;33(10):777–786. PMID: 31250680. https://doi.org/10.1089/end.2019.0309
32. Young M, Leslie SW. Percutaneous nephrostomy. In: Stat-Pearls. StatPearls Publishing; 2023. PMID: 29630257.
33. Pabon-Ramos WM, Dariushnia SR, Walker TG, et al; Society of Interventional Radiology Standards of Practice Committee. Quality improvement guidelines for percutaneous nephrostomy. J Vasc Interv Radiol. 2016;27(3):410–414. PMID: 26803576. https://doi.org/10.1016/j.jvir.2015.11.045
34. Mondal U, Viswanathan S, Sreenivasan Kodakkattil S. Percutaneous nephrostomy in complicated urinary tract infections. Cureus. 2022;14(7):e26682. PMID: 35949777. PMCID: PMC9358986. https://doi.org/10.7759/cureus.26682
35. Hedin M. The origin of the word Stent. Acta Radiol. 1997;38(6):937–939. PMID: 9394645. https://doi.org/10.1080/02841859709172106
36. Polat ME, Karaaslan M, Yilmaz M, Olcucuoglu E, Sirin ME. The effect of ureteral double J stent insertion on work performance in patients undergoing endoscopic stone treatment. Cent European J Urol. 2024;77(1):117–121. PMID: 38645805. PMCID: PMC11032031. https://doi.org/10.5173/ceju.2023.110
37. Geavlete P, Georgescu D, Mulțescu R, Stanescu F, Cozma C, Geavlete B. Ureteral stent complications – experience on 50,000 procedures. J Med Life. 2021;14(6):769–775. PMID: 35126746. PMCID: PMC8811679. https://doi.org/10.25122/jml-2021-0352
38. Sali GM, Joshi HB. Ureteric stents: overview of current clinical applications and economic implications. Int J Urol. 2020;27(1):7–15. PMID: 31549458. https://doi.org/10.1111/iju.14119
39. Heimberger M, Stocchi L, Brennan E, et al. Can preoperative ureteral stent placement help in the intraoperative identification of iatrogenic ureteral injury?. J Gastrointest Surg. 2024;28(6):903–909. PMID: 38555016. https://doi.org/10.1016/j.gassur.2024.03.028
40. Reicherz A, Maas V, Wenzel P, et al. Transient stent placement versus tubeless procedure after ureteroscopy retrograde surgery stone extraction (Fast Track Stent study 2): a randomized prospective evaluation. Int J Urol. 2020;27(9):749–754. PMID: 32974894. https://doi.org/10.1111/iju.14291
41. Lory A, Stubbs C, Wolstenhulme S, Khan A. Urinary tract obstruction: ultrasound-guided intervention. Ultrasound. 2022;30(4):264–272. PMID: 36969536. PMCID: PMC10034656. https://doi.org/10.1177/1742271X211049495
42. Corvino A, Basile L, Cocco G, et al. Complications subsequent to urinary tract stent placement: an overview focusing on the imaging of cancer patients. Medicina (Kaunas). 2024;60(2):338. PMID: 38399625. PMCID: PMC10890112. https://doi.org/10.3390/medicina60020338
43. Bellos TC, Manolitsis IS, Katsimperis SN, et al. Ureteral stent related symptoms: a comparative study. Arch Ital Urol Androl. 2024;96(1):12231. PMID: 38441229. https://doi.org/10.4081/aiua.2024.12231
44. Janssen P, Tailly T. New stent technologies. Urol Clin North Am. 2022;49(1):185–196. PMID: 34776051. https://doi.org/10.1016/j.ucl.2021.08.004
45. Tomer N, Garden E, Small A, Palese M. Ureteral stent encrustation: epidemiology, pathophysiology, management and current technology. Reply. J Urol. 2022;207(1):249–250. PMID: 33591806. https://doi.org/10.1097/JU.0000000000001679
46. Policastro C, Dispagna M, Smith G, Byler T, Wiener S. Factors associated with unplanned clinical encounters for ureteral stent-related symptoms. World J Urol. 2024;42(1):74. PMID: 38324162. https://doi.org/10.1007/s00345-024-04768-x
47. Ahmad MU, Siddiqui S, Ashraf FA, et al. Retrograde ureteral stents versus percutaneous nephrostomy in the management of malignant ureteral obstruction: a systematic review and meta-analysis. Urology. 2024;192:158–167. PMID: 38830555. https://doi.org/10.1016/j.urology.2024.05.042
48. Moon YJ, Jun DY, Jeong JY, Cho S, Lee JY, Jung HD. Percutaneous nephrostomy versus ureteral stent for severe urinary tract infection with obstructive urolithiasis: a systematic review and meta-analysis. Medicina (Kaunas). 2024;60(6):861. PMID: 38929478. PMCID: PMC11206041. https://doi.org/10.3390/medicina60060861
49. Cozma C, Georgescu D, Popescu R, Geavlete B, Geavlete P. Double-J stent versus percutaneous nephrostomy for emergency upper urinary tract decompression. J Med Life. 2023;16(5):663–667. PMID: 37520483. PMCID: PMC10375355. https://doi.org/10.25122/jml-2022-0334
50. Suçeken FY, Beyatlı M, Güngör S, Karaca H, Küçük EV, Sarıca K. Efficacy and safety of two different approaches in the drainage of the upper urinary tract in “acute obstructive uropathy”: a critical evaluation. J Endourol. 2025;39(1):84–89. PMID: 39653362.
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For citations:
Gazimiev E.S., Medvedev V.L., Dmitrenko G.D., Palaguta G.A., Vitaev A.A., Sergeev V.V. Obstructive Uropathy: Causes, Treatment, and Analysis of Complications. Innovative Medicine of Kuban. 2025;10(2):135-142. (In Russ.) https://doi.org/10.35401/2541-9897-2025-10-2-135-142
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