Ureteral obstruction

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Classification according to ICD-10
Q62.1 Atresia and (congenital) stenosis of the ureter
N13.1 Hydronephrosis in ureteral stricture, not elsewhere classified
N13.5 Kink and stricture of the ureter without hydronephrosis
ICD-10 online (WHO version 2019)

The ureteral stenosis ( UAS ) is a narrowing of the transition from the renal pelvis to the ureter . It is usually congenital; it can rarely be caused by an adjacent blood vessel.

Scheme: ureteral stenosis

Symptoms

The constriction leads to a build-up of urine in the renal pelvis, which can lead to abdominal and flank pain, especially after drinking more fluids. Urinary tract infections occur more frequently due to the obstruction to drainage, and the enlarged renal pelvis is rarely palpable as a "tumor".

Diagnosis

Today, the suspected diagnosis is usually made during an ultrasound examination of the kidneys, in many cases already prenatally . A one-sided enlargement of the renal pelvis is then noticeable. A kidney scintigraphy can be performed to estimate the functional part of the affected kidney and to quantify the extent of the flow obstruction .

therapy

If less than 40% of the urine drains from the renal pelvis and if there is pain or repeated infections, an operation should be performed. As a rule, the ureter, including the narrowness and part of the renal pelvis, is cut off and then the ureter is sewn back into the renal pelvis and the renal pelvis is closed (surgery according to Anderson-Hynes).

If the kidney function is less than 10% on the affected side, removal of the kidney may be indicated.

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