From the Guidelines
Oléis (olive oil) should not be used in cases of obstructive uropathy, as it has no established role in treating urinary obstructions and may delay necessary medical care, potentially leading to complications such as kidney damage, urinary tract infections, or sepsis. Obstructive uropathy is a medical emergency that often requires prompt intervention, such as percutaneous nephrostomy (PCN) catheter placement, to provide access into the renal collecting system for urinary decompression and to facilitate endourologic surgery 1. The use of PCN has been proven to be a safe and effective technique with limited morbidity and mortality, and its indications have expanded over the years 1. Treatment of obstructive uropathy typically involves addressing the underlying cause of the obstruction, which may include kidney stones, tumors, enlarged prostate, or congenital abnormalities. Management often includes placement of urinary catheters, stents, or surgical procedures to relieve the obstruction. In cases of infection secondary to obstruction, appropriate antibiotics are necessary, and pain management may include medications like NSAIDs or opioids depending on severity.
Some key points to consider in the management of obstructive uropathy include:
- Prompt medical attention is necessary to prevent complications such as kidney damage or sepsis
- PCN catheter placement is a safe and effective technique for urinary decompression and endourologic surgery 1
- Treatment should be tailored to the underlying cause of the obstruction
- Antibiotics and pain management may be necessary in addition to relief of the obstruction
- Delaying medical care to try alternative remedies like olive oil can lead to serious complications.
It is essential to seek immediate medical attention if symptoms of urinary obstruction occur, such as decreased urine output, flank pain, or abdominal discomfort.
From the Research
Obstructive Uropathy Overview
- Obstructive uropathy is defined as the structural or functional interruption of urinary outflow at any level in the urinary tract 2
- It is regarded as one of the most prevalent causes of acute kidney injury (AKI), accounting for 5%-10% of cases 2
- Acute severe obstruction of the urinary tract is a potentially threatening situation for the kidneys and therefore requires prompt identification and management to relieve obstruction 2
Treatment Options
- Percutaneous nephrostomy (PCN) and retrograde ureteral stenting (RUS) are two main treatment options for acute upper obstructive uropathy 3
- PCN and RUS are effective for the decompression of an obstructed urinary system, with no significant difference in most outcomes 3
- However, PCN is preferable to RUS because of its reduced impact on the patient's post-operative quality of life due to haematuria and dysuria, although it is associated with slightly longer hospitalisation duration 3
- Double-J ureteral stent and percutaneous nephrostomy are also used to treat obstructive uropathy due to stone disease, with percutaneous nephrostomy having a higher success rate and fewer complications 4
Management and Complications
- Early recognition of the leading cause and its exact location is essential to ensure prompt urinary drainage together with the most suitable drainage technique selection 2
- A multidisciplinary approach, including urologists, nephrologists, and other medical specialties, is best suited to correctly manage concomitant hemodynamic changes, fluid and electrolyte imbalances, and other related issues 2
- Complications of obstructive uropathy include haematuria, dysuria, septicemia, painful trigon irritation, and stent encrustation 3, 4
- Therapy for obstructive uropathy is largely determined by whether the obstruction involves one or both kidneys, and by the age of the patient 5