Zhu Grace G, Rais-Bahrami Soroush
Department of Urology, University of Alabama at Birmingham, Birmingham, AL, USA.
Department of Radiology, University of Alabama at Birmingham, Birmingham, AL, USA.
J Nephrol Res. 2015;1(3):90-96. Epub 2015 Dec 29.
Obstructive uropathy is a common urological problem, with a variety of etiologies, ranging from benign to malignant processes, extrinsic to intrinsic conditions. Its presentation depends largely on the location of the obstructive lesion and the acuity of the obstruction. Lower versus upper urinary tract obstruction present differently. A wide variety of imaging tools can aid in diagnosing the obstructive process and help delineate the etiology and the location of the obstruction. Treatment is geared towards alleviating the obstruction, either by restoring the normal urinary flow within the urinary tract by utilizing a ureteral stent for upper urinary tract obstruction or urethral catheters for lower urinary tract obstruction, or by diverting the urine by placing a percutaneous nephrostomy tube or suprapubic catheters. Pelvic malignancies are a subset of the many causes of obstructive uropathy and have unique considerations in treatment. Future directions in the realm of management of obstructive uropathy should focus on maximizing urinary drainage while minimizing the morbidities associated with the current available treatment options.
梗阻性尿路病是一种常见的泌尿系统问题，病因多样，涵盖从良性到恶性的各种病变，包括外在因素和内在因素。其临床表现很大程度上取决于梗阻性病变的位置以及梗阻的严重程度。下尿路梗阻与上尿路梗阻的表现有所不同。多种影像学检查手段有助于诊断梗阻过程，并明确梗阻的病因及部位。治疗旨在缓解梗阻，可通过在上尿路梗阻时使用输尿管支架或在下尿路梗阻时使用尿道导管来恢复尿路内正常的尿液流动，或者通过放置经皮肾造瘘管或耻骨上导尿管来改道尿液。盆腔恶性肿瘤是梗阻性尿路病众多病因中的一部分，在治疗上有独特的考量。梗阻性尿路病管理领域的未来发展方向应聚焦于在最大限度引流尿液的同时，尽量减少与现有治疗方案相关的并发症。
