Obstructive uropathy (note, we're only discussing the mechanical causes of ARU)

Consequence of Obstructive uropathy:
1. Pain (acute)
2. Infection (stasis is the basis for infection) (Acute and chronic)
3. Loss of renal function (chronic)

Complete obstruction:
1 day: renal impairment begins
1 week: irreversible renal damage

Causes of Obstructive Uropathy:
Causes of obstructive uropathy may be grouped into luminal, mural and extramural causes:

1. Luminal causes
- Stones (commonest)
- Foreign bodies
- blood clots

2. Mural causes
- Strictures secondary to infection, trauma (e.g. passage of stones, instrumentation)
- tumours
- dysfunctional sphincters
- urthreitis

3. Extramural causes
- prostate
- tumour
- LN
- fecal loading
- pregnancy
- UV prolapse

Site specific: Causes of mechanical obstruction in

Kidney
Luminal: stones
Mural: tumours, strictures --> PUJO (presents in young patients who suffer a bout of renal colic, loin to groin pain when drinking too much water or taking diuretics or food with similar effects)

Ureters:
Luminal: stones
Mural: tumours, strictures
Extramural: pelvic masses, abdominal masses, tumours, LNs, fecal loading, pregnancy

Bladder:
Luminal: Stones, FB
Mural: strictures, tumours, dysfunctional sphincters, urethreitis
Extramural: prostate, fecal loading, UV prolapse, tumour

BPH:
>50 years old
>67 years old as mean
S/S:
1. ARU
2. LUTS (voiding and irritative symptoms)
3. bladder stones, stasis, infection, hydronephrosis, pyelonephritiis
4. overflow incontinence

Voiding symptoms: frequency, urgency, nocturia

Obstructive symptoms: hesitancy, straining, poor stream, end-dribbling, incomplete voiding