A urinary obstruction can result from any growth or narrowing that partially or totally blocks the normal passage of urine anywhere between the kidneys and its exit from the body through the urethra. In most cases, the obstruction is only partial, so that urine flow is restricted. For example, the flow may be reduced and marked by dribbling before or after normal urination. In some instances, attempting to urinate produces pain or burning. Though rare, total obstruction sometimes occurs, in which there is no urination; medical intervention must be immediate to prevent urine from backing up into the kidneys and damaging those vital organs. Up to 15 percent of the population is born with urinary tract abnormalities, such as a muscle or nerve problem that affects the ureters or bladder. Most of these disorders never cause any difficulty, but the following can be serious:
- A marked narrowing of a ureter, either at the point where it meets the kidney or where it meets the bladder .
- A shortening of the outlet where urine leaves the bladder, a condition known as vesical neck contracture.
- Bands of fibrous tissue in the urethra that narrow it. Urinary tract obstructions can also be acquired; common causes include:
- Enlargement of the prostate gland, due to benign overgrowth or cancer .
- Inflammatory conditions, including cystitis, or inflammation, of the bladder, and prostatitis, a disorder of the prostate gland .
- Genitourinary tumors, which may arise in the bladder, ureters, kidneys, or nearby organs, such as the prostate, uterus, or cervix .
- Sagging pelvic muscles that make the bladder shift position, a common condition among older women .
- Injury or scar tissue that is caused by infections, radiation treatments, surgery, or trauma.
- The use of cold pills and other drugs that interfere with urinary flow.
Other Causes of Urinary Tract Obstruction
In addition to the conditions already listed, urinary obstructions may be the result of kidney or bladder stones, cancer and other tumors, and a variety of structural abnormalities.
Diagnostic Studies And Procedures
Diagnosis typically begins with a physical examination and routine blood and urine studies. The lower urinary tract may be inspected by uroscopy, in which a viewing tube with lights and magnifying devices is inserted into the urethra and bladder. Imaging procedures may include intravenous urography, X-rays taken after injection of a dye that outlines the kidney and ureter; retrograde pyelography, in which the dye is injected through the urethra into the bladder, ureters, and kidney; or anterograde pyelography, in which a catheter is inserted into a dilated ureter at a point above the obstruction and then dye is injected. Ultrasound and CT scans, which are less invasive, can often pinpoint the underlying problem as well.
Medical Treatments to Get Rid of Urinary Obstruction
Some ureteral obstructions can be resolved during anterograde pyelography; for others, a doctor may be able to provide immediate relief by inserting a catheter, a thin, flexible tube, through the urethra and into the bladder. If the obstruction is in the lower urinary tract, blocked urine may immediately flow out through the catheter. Further treatment depends on the cause and location of the obstruction. Antibiotics will be prescribed for urinary tract infections. Tumors may be treated by surgical removal, chemotherapy, radiation, or a combination of these methods. Congenital problems often require surgery. Depending on the site of obstruction, surgery may be done using tiny instruments inserted through the urethra or an incision in the abdomen.
Because a urinary tract obstruction potentially threatens the kidneys, a physician must diagnose the condition. Depending upon the cause, some alternative therapies may be useful adjuncts to medical treatment.
Herbalists recommend tinctures or infusions of red clover, catnip, or bearberry for a variety of urinary disorders. Herbal diuretics include juniper, saw palmetto, and gravelroot, which can be taken as tinctures or infusions.
Drinking two or three glasses of cranberry juice, preferably in unsweetened form, every day acidifies urine and helps to prevent bladder inflammation. Some naturopaths recommend taking high doses of vitamin C, but many doctors discourage this practice because it can promote bladder stones and irritation.
Drink at least eight glasses of water, diluted juice, and other nonalcoholic beverages a day to help flush out the urinary tract. It is best to abstain from alcohol and caffeine, which can cause bladder irritation and urinary urgency. Also, do not take over the counter cold and allergy pills, as they can cause urinary retention. Beyond these steps, urinary tract obstructions generally cannot be self treated. However, if you are suddenly unable to pass urine but have no pain, take a warm bath. If the problem persists, you should call your physician.