Ahmed Sajjad, Saadat Hassan Hashmi, Masroor Hussain Malik, Zein El Amir, Sharjil Wahid, Faraz Munir Butt.
Obstructive Uropathy.
J Rawal Med Uni Jan ;22(2):124-8.

Background: To determine major causes of obstructive uropathy and various treatment modalities that we could offer to relieve the obstruction and to find out the outcome in terms of renal impairment and mortality. Methods: In this prospective observational study patients who presented with obstruction in drainage of urine resulting in an elevated serum Creatinine of more than 1.5 mg/dl, were included. Cause of obstruction was established with appropriate investigations and treatment was then tailored according to the diagnosis and outcomes observed. Results: Most common etiology was found to be urolithiasis (49.8%) followed by bladder outlet obstruction ( 31.1%). Kidney diversion/PCN was done in 12.82% patients, double J Stenting in 12.08%, percutaneous nephrolithotomy in 5.49% patients, ureterorenoscopy, insitu lithotripsy and stenting in 16.48%. Other procedures were TURP in 14.65%, suprapubic catheterization or optical uretherotomy in 7.32% and TURBT in 8.05%. However, 6.22% patients failed to improve despite adequate management and were put on maintenance hemodialysis. Eleven (4.07%) expired during the course of management. Conclusion: The leading cause of obstructive uropathy was urolithiasis. Ultrasound guided percutaneous nephrostomy and double J stenting were quick method of temporary urinary drainage, in cases with urolithiasis . Timely diversion of urine and subsequent skilled management can prevent the patients from progression to end stage renal disease.

PakMediNet -Pakistan's largest Database of Pakistani Medical Journals - http://www.pakmedinet.com