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Extrinsic Obstruction of the Ureter

The ureter is a thick and long tube which connects the kidneys to the bladder. It is normally around 10 inches long with the upper half in the abdomen while the lower portion lies in the pelvic region.

At times, this ureter can get obstructed and result in a condition called the extrinsic obstruction of the ureter.

What is extrinsic obstruction of the ureter?

Extrinsic obstruction of the ureter is caused when the organs gets diseased and press against the ureter, creating a blockage in the ureter. This, in turn, affects the normal drainage and flow of urine from the kidney into the bladder. The accumulation of urine in the ureter can also result in injury to the kidney.

What causes extrinsic obstruction of the ureter?

There are several causes that lead to extrinsic obstruction of the ureter, such as:

• Vascular disease

• Benign female reproductive system disorders (mass uterine or ovarian lesions, pregnancy complications, endometriosis, intra-operative ureteral injury, Gartner’s duct cyst, etc)

• Gastrointestinal tract diseases (Crohn’s disease of the bowel, inflammatory appendix disorder, pancreatic lesions, etc)

• Retro-peritoneum diseases

What are the signs and symptoms of extrinsic obstruction of the ureter?

Mostly, the progress of the disorder is slow and symptoms develop late. In case the obstruction is acute there will be significant pain.
Other symptoms may include nausea, vomiting, fever, urinating problems, bloody or cloudy urine, etc.

What are the diagnostic tests for extrinsic obstruction of the ureter?

Extrinsic obstruction of the ureter is one of those commonly seen disorders where the diagnosis can be difficult sometimes. This requires using imaging diagnostic tests to establish correct diagnosis.

Diagnostic imaging tests for detecting extrinsic obstruction of the ureter may include:

• Ultrasound

• IVP (intravenous urography)

• CT (computerized tomography) scans

• MRI (magnetic resonance imaging) tests

These help in viewing the location and severity of the blockage in the ureter. Urinalysis and other laboratory tests are also advised for testing the affect on kidney functions from the obstruction.

What is the treatment for extrinsic obstruction of the ureter?

The treatment for extrinsic obstruction of the ureter mainly depends on the severity and exact location of the obstruction.
Initially, the doctor will attempt to drain the kidney properly. The doctor may use a ureteral stent or perform a nephrostomy procedure for this.
Following the successful draining of the urine from the kidney the doctor or surgeon will focus on treating the other symptoms that are noticed in the individual case.

What is the outcome of treatment of extrinsic obstruction of the ureter?

The results vary with each case. In case the damage to the kidney is permanent then there is little choice for the doctors. However if the obstruction is detected and removed in time, there may only be temporary damage which can be efficiently treated.

In case only one kidney was affected the other kidney is able to perform the filtering function as effectively if it is healthy.

Frequently asked questions:

What are the risk factors that can cause extrinsic obstruction of the ureter?

The main risk is the growth of tumors or stones in the surrounding organs.