Ureteric obstruction

Ureteric obstruction is a blockage in one or both of your ureters. The ureters are the tubes that transport urine from the kidneys to the bladder. Ureteric obstruction is a fairly common condition (usually because of a ureteric stone) which can become extremely painful and even life-threatening if not treated.

Some of the symptoms associated with ureteric obstruction are:

Abdominal pain in one or both sides
Fever
Haematuria
Difficulty urinating
Urinary tract infections

The pain can range from mild discomfort to extremely painful, some patients may experience nausea or vomiting and fever and chills.

There are many conditions that can cause ureteric obstruction such as:

Ureteral stones – kidney stones that have travelled into the ureter from the kidney
Genetic and congenital disorders such as ureteropelvic junction obstruction and duplication of the ureter
Pregnancy
Endometriosis – tissue similar to the lining of the womb grows in other places, such as the ovaries and fallopian tubes
Tumours
Long-term swelling

Diagnosing ureteric obstruction

To diagnose ureteric obstruction, your doctor will have an initial consultation with you to talk through your symptoms. You may be offered blood or urine tests to check for any infection or for your kidney function. You may be offered other tests, such as an ultrasound, CT scan, MRI scan or a nuclear medicine study.

You may need further investigations, such as a cystoscopy. During a cystoscopy, a thin tube with a camera on the end is inserted into your urethra and bladder.

This leaflet from the BAUS (British Association of Urological Surgeons) contains more information about having a cystoscopy.

Download leaflet

Treating a ureteric obstruction

Ureteric obstruction is usually treated by removing the cause (such as removing a stone) in order to relieve any pain and discomfort and repair the damage caused.

Your doctor may want to drain the body of urine to temporarily relieve the pain caused by the blockage. A catheter may be placed inside the urethra to drain urine from the bladder and you may need a ureteric stent. This is placed inside your ureter to keep it open. A percutaneous nephrostomy may also be offered, this procedure subsequently drains urine direct from the kidneys by a tube inserted through your back. Once your kidney has had the blockage relieved your doctor will be able to assess the best approach on how to treat your ureteral obstruction.

Some treatment options include:

Endoscopic surgery

This is a minimally invasive procedure where a long flexible tube with a camera on the end is inserted into the ureter. Your surgeon will use the image from the camera to see inside your urinary tract. They will then assess the obstruction and use instruments to remove the blockage.

Laparoscopic surgery

This is minimally invasive surgery, also known as keyhole surgery. Your surgeon will make a small incision in your abdomen and insert a small thin tube with a camera on the end to see inside your body. They will then assess the obstruction and use instruments to remove the blockage.