WordNet

any pathology of the urinary tract

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妨害する,じゃまする;(…を)妨害する《+『of』+『名』》

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2018/05/02 03:30:47」(JST)

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Obstructive uropathy is a structural or functional hindrance of normal urine flow,^[1] sometimes leading to renal dysfunction (obstructive nephropathy).

It is a very broad term, and does not imply a location or cause.

Causes

It can be caused by a lesion at any point in the urinary tract.^[2]

Causes include urolithiasis,^[3] posterior urethral valves and ureteral herniation.^[3]

Symptoms

Symptoms, less likely in chronic obstruction, are pain radiating to the T11 to T12 dermatomes, anuria, nocturia, or polyuria.

Diagnosis

Diagnosis is based on results of bladder catheterization, ultrasonography, CT scan, cystourethroscopy, or pyelography, depending on the level of obstruction.

Treatment

Treatment, depending on cause, may require prompt drainage of the bladder via catheterization, medical instrumentation, surgery (e.g., endoscopy, lithotripsy), hormonal therapy, or a combination of these modalities.

Treatment of the obstruction at the level of the ureter:

Open surgery.
Less invasive treatment: laparoscopic correction.
Minimal invasive treatment: Overtoom procedure:^[4] dilatation with cutting balloon catheter (e.g., Boston Scientific) followed by introduction of the pyeloplasty balloon catheter.^[5] This balloon is inflated with pure contrast agent via the pusher and remains in situ in the ureter to keep the previous treated stricture dilated while the expanded urothelium heals. Urine can drain through the central channel of this catheter.

References

^ Definition: obstructive uropathy from Online Medical Dictionary.
^ Kumar, Vinay; Fausto, Nelson; Fausto, Nelso; Robbins, Stanley L.; Abbas, Abul K.; Cotran, Ramzi S. (2005). Robbins and Cotran Pathologic Basis of Disease (7th ed.). Philadelphia, Pa.: Elsevier Saunders. p. 1012. ISBN 0-7216-0187-1.
^ ^a ^b Tsai PJ, Lin JT, Wu TT, Tsai CC (September 2008). "Ureterosciatic hernia causes obstructive uropathy". J Chin Med Assoc. 71 (9): 491–3. doi:10.1016/S1726-4901(08)70155-2. PMID 18818145. ^{[dead link]}
^ Treatment of ureteropelvic junction obstruction using a detachable inflatable stent: initial experience by Timotheus T C Overtoom, Peter L Vijverberg, Hendrik W van Es, Sandrine van Selm, Hans P M van Heesewijk
^ "Overtoom balloon". www.overtoomballoon.com. Retrieved 2016-10-15.

UpToDate Contents

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1. 尿路閉塞および水腎症の臨床症状および診断 clinical manifestations and diagnosis of urinary tract obstruction and hydronephrosis
2. 急性尿閉 acute urinary retention
3. 胎児水腎症の概要 overview of fetal hydronephrosis
4. 成人における慢性腎臓病マネージメントの概要 overview of the management of chronic kidney disease in adults
5. 尿管ステントの留置およびマネージメント placement and management of indwelling ureteral stents

English Journal

Effect of stem cells on renal recovery in rat model of partial unilateral upper ureteric obstruction.

Sugandhi N, Srinivas M, Agarwala S, Gupta DK, Sharma S, Sinha A, Dinda A, Mohanty S.Author information Department of Pediatric Surgery, All India Institute of Medical Sciences, New Delhi, India, drnidhisugandhi@gmail.com.AbstractBACKGROUND: Untreated obstructive uropathy produces irreversible renal damage and is an important cause of pediatric renal insufficiency. This study was designed to evaluate the effects of stem cell injection on morphological and pathological changes in the rat kidneys with partial unilateral upper ureteric obstruction (PUUUO).
Pediatric surgery international.Pediatr Surg Int.2014 Feb;30(2):233-8. doi: 10.1007/s00383-013-3456-8.
BACKGROUND: Untreated obstructive uropathy produces irreversible renal damage and is an important cause of pediatric renal insufficiency. This study was designed to evaluate the effects of stem cell injection on morphological and pathological changes in the rat kidneys with partial unilateral upper
PMID 24370792

Laparoscopic Ureterolysis and Omental Wrapping in Patients with Retroperitoneal Fibrosis and Obstructive Uropathy: A Single-Center Experience.

Arvind NK, Singh O, Ali Q, Singh J, Gupta SS, Sahay S.Author information 1 Department of Urology, Bhopal Memorial Hospital & Research Centre , Bhopal, India .AbstractAbstract Objectives: To analyze the outcomes with mid- to long-term follow-up of laparoscopic ureterolysis (LU) and omental wrapping in retroperitoneal fibrosis (RPF) with obstructive uropathy. Patients and Methods: Records of 9 patients with RPF who had obstructive uropathy at presentation and had undergone LU and omental wrapping at our center during January 2004 to June 2012 were collected and analyzed. Results: Six females and three males underwent LU for RPF. Underlying causes of RPF could not be found in 8 (89%) cases. Two patients underwent bilateral LU. Mean operative time and estimated blood loss were 213 minutes (range, 180-280 minutes) and 119 mL (range, 70-200 mL), respectively. No case required conversion to open surgery. The only significant intraoperative complication (1/9 [11%]) was ureteral injury, which was easily repaired intraoperatively. The postoperative complication rate was 44% (4/9). Most complications (75% [3/4]) were minor and did not need specific treatment. The mean follow-up period was 46 months (range, 4-72 months). The success rate at last follow-up was 89%. Conclusions: Treatment of RPF is still controversial. Any future prospective randomized comparative trials seem unlikely in view of the low incidence of RPF. LU and omental wrapping in the setting of obstructive uropathy are safe and an effective alternative with a high success rate at mid- to long-term follow-up.
Journal of laparoendoscopic & advanced surgical techniques. Part A.J Laparoendosc Adv Surg Tech A.2014 Jan 30. [Epub ahead of print]
Abstract Objectives: To analyze the outcomes with mid- to long-term follow-up of laparoscopic ureterolysis (LU) and omental wrapping in retroperitoneal fibrosis (RPF) with obstructive uropathy. Patients and Methods: Records of 9 patients with RPF who had obstructive uropathy at presentation and had
PMID 24479819

Urinary schistosomiasis.

Bamgbola OF.Author information Division of Pediatric Nephrology, Children's Hospital of New Orleans, Louisiana State University Health Science Center, 200 Henry Clay Avenue, New Orleans, LA, 70118, USA, fbamgbola@gmail.com.AbstractSchistosomiasis is the second most common socio-economically devastating parasitic disease after malaria, affecting about 240 million residents of developing countries. In Africa, it predominantly manifests as urogenital disease, and the main infective agent is Schistosoma hematobium. Endemicity is propagated by poor socio-economic status and environmental degradation due to rapid urbanization. Recreational swimming is a potent medium for the spread of disease in children and adolescents. Most affected individuals are asymptomatic. The male and female worms are equipped with an extraordinary capacity for immune evasion and are able to co-habit for several decades within the pelvic venous plexus. Eggs deposited in the bladder wall resist elimination by type 1 T lymphocytes. Instead, they are sustained by pro-fibrogenic encapsulation (as modulated by type 2 helper cells). Progressive bladder disease results in obstructive uropathy and predisposes to (mostly) squamous cell carcinoma. Schistosomal glomerulopathy manifests as a clinical spectrum of asymptomatic proteinuria, nephrosis and/or nephritic syndrome. Findings on renal biopsy may be influenced by co-morbidity with Salmonella bacteria, amyloidosis and hepatitis C infection. Potentially fatal Katayama fever and spinal radiculopathy may ensue in tourists visiting an endemic zone. Early detection by urine microscopy is hampered by low urinary excretion rates of the parasite eggs. Although useful in travelers with newly acquired disease, the results of the serological antibody assay may be false positive in residents of an endemic zone. Cystoscopy, however, may be invaluable. Due to its safety, effectiveness and once-daily dosing, praziquantel is the drug of choice. An integrated approach that includes mass chemotherapy, environmental health programs and public health education is the most cost-effective preventive strategy.
Pediatric nephrology (Berlin, Germany).Pediatr Nephrol.2014 Jan 28. [Epub ahead of print]
Schistosomiasis is the second most common socio-economically devastating parasitic disease after malaria, affecting about 240 million residents of developing countries. In Africa, it predominantly manifests as urogenital disease, and the main infective agent is Schistosoma hematobium. Endemicity is
PMID 24469437

Japanese Journal

CAKUT(congenital anomalies of the kidney and urinary tract)に対する画像検査—排尿時膀胱尿道造影(VCUG)と核医学検査—

白柳慶之,山崎雄一郎
Nihon Shoni Jinzobyo Gakkai Zasshi 26(1), 33-42, 2013
　CAKUTは尿路における先天異常の総称で腎臓(e.g. 腎低形成，腎異形成)，腎盂尿管(e.g. 水腎症，巨大尿管症)，膀胱(e.g. 尿管瘤，膀胱尿管逆流(VUR))，尿道(e.g. 後部尿道弁(PUV))などの疾患を含む。胎児期に発見されるCAKUTは中枢神経系の異常に次いで多く，全出生の0.3～0.6%にのぼる。出生後早期にVCUGを行った方が良い病態は，1．膀胱の変形，壁の肥厚・巨大膀胱 …
NAID 130003384552

Obstructive Uropathy Caused by Atherosclerotic Abdominal Aortic Aneurysm

Wu Chia-Jung,Hou Sen-Kuang,How Chorng-Kuang,Hung-Tsang Yen David
Internal Medicine 51(1), 133-133, 2012
NAID 130002062439

症例報告全前置胎盤術後に水腎症を伴わない急性腎後性腎不全を呈した1例

石井晶子,松本隆万,山村倫啓 [他]
東京産科婦人科学会会誌 60(4), 656-660, 2011-12
NAID 40019362069

「閉塞性尿路疾患」

Obstructive uropathy
Classification and external resources
Specialty	urology
ICD-10	N13
ICD-9-CM	599.60
MedlinePlus	000507
eMedicine	radio/804
	[edit on Wikidata]

　　[★]

英: obstructive uropathy
関: [[]]

閉塞性尿路疾患(http://merckmanual.jp/mmpej/sec17/ch229/ch229a.htmlより引用)
閉塞性尿路疾患は正常な尿流を構造的または機能的に妨げ，ときに腎機能不全（閉塞性腎症）を起こすことがある。症状は，慢性の閉塞では認められないこともあるが，T11からT12にかけての皮膚分節に放散する疼痛，無尿，夜間頻尿または多尿がある。診断は閉塞のレベルによって，膀胱カテーテル法，超音波検査，CT，膀胱尿道鏡検査，膀胱尿道撮影または腎盂造影に基づく。治療は原因によって異なり，迅速なドレナージ，器具使用，外科手術（例，内視鏡法，砕石術）および/またはホルモン療法を必要とする場合がある。