EXPERIENCE OF OBSTRUCTIVE UROPATHY

CLINIC; MANAGEMENT AND OUTCOME

H. Mazahir Zulfiqar*, Ahmed Sajjad*, Mumtaz Ahmed**
*

Department of Urology and Renal Transplant, Rawalpindi

Medical College, Benazir Bhutto Hospital, Rawalpindi,
**
Head of Department of Urology and Renal Transplant.

OBJECTIVE
Experience

in

obstructive

management and outcome.

uropathy

clinic,

its

MATERIALS & METHODS

 Study was conducted from October 2013 to March 2015.

Patients with elevated serum creatinine > 1.5 mg/dl, evidence of

obstruction in the urinary tract, were included in the study.

Their details were recorded on a pre-designed performa.

Detailed history followed by clinical examination, noting of the bio

chemical profile, sonological and radiological findings were done.

Admitted, and treatment offered depending on the cause of the

obstruction.
The outcome, considered in terms of, obstruction relieved resulting in

normalization of serum creatinine.

RESULTS

 Out of the 84 patients

included in the study,

Age ranged 16 to 86

yrs. (mean 54.1 yrs.).

Male to female ratio

was 2.2:1.

 Forty three (51%) patients

belonged from the Rawalpindi

district,

Followed by 9 (10.7%) coming

from A.J.K.

 Major admissions were

made through:

Emergency (61.9%)

patients.

Out patient (38.1%)

patients.

ER:OPD ratio of 1.5:1.

 With regards to their Serum

creatinine derangements:
Serum
Creatinine
(mg/dl)

Population
number

Percentage
(%)

1.6 5.9
(mild)

30

35.7

6 10
(Moderate)

28

33.3

10
(severe)

26

30.9

Total

84

100%

 It was seen that time elapsed

since onset of uremic symptoms

(nausea, vomiting, altered
consciousness) and presentation
to the hospital was greater than 2
weeks in 41 (48.8%) of the
patients.

 As for the cause of Obstructive Uropathy :

Aetiology

Population
Number

Percentage (%)

Bladder Outflow Obstruction due to

Prostate

20

23.8

BOO due to stricture of Urethra

9.5

Solitary functioning kidney with Renal

Calculus only

8.3

Solitary kidney with Ureteric Calculus

only

2.3

Bilateral Ureteric Calculus Obstruction

4.7

Bilateral Renal Stones

18

21.4

Renal with Ureteric stone

11

13

Bladder tumor causing upper tract

obstruction

9.5

Infiltrating Pelvic Cancers

(Cervical cancers, Uterine Cancers)

7.1

Total

84

100

 Treatment that were offered:

Treatment

Population
Number

Percentage (%)

PCN

28

33.3

Stenting

14

6.6

URS+in situ
lithotripsy+stenting

4.7

Suprapubic Cystostomy

9.5

Conservative

22

26.1

Put on Renal Replacement

therapy

4.7

Expired

4.7

Total

84

100

Outcome

CONCLUSION

 Obstructive

uropathy is a

true urological emergency.

If

urinary

diversion

and

skilled management is done

within good time can result
in

saving

the

functional

ability of the kidneys, and

hence

decrease

morbidity

and mortality of the patient.