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Understanding the details of ureteral obstruction is crucial for maintaining good health, as it can lead to serious complications. The ureters, which are tubes that carry urine from the kidneys to the bladder, can become blocked, resulting in significant pain. This condition is known as ureteral obstruction. There are many causes for this blockage, including kidney stones, tumors, infections, or scar tissue, which may affect one or both ureters.

If left untreated, the blockage can lead to kidney damage, kidney failure, or even infection. Some symptoms of ureteral obstruction include severe pain in the back or sides, blood in the urine, difficulty urinating, or frequent urinary tract infections. Early diagnosis is vital to protect kidney function and ensure the urinary system operates smoothly.

In a conversation with Jagran English, Dr. Raghavendra Kulkarni, a consultant urologist at the Asian Institute of Nephrology and Urology in Hyderabad, explained ureteral obstruction and its causes and symptoms.

According to Dr. Raghavendra, urinary obstruction refers to a blockage in the urinary tract that disrupts the normal flow of urine. The ureter is a tubular structure responsible for transporting urine from the kidney to the bladder. Ureteral obstruction is critical because, if not addressed in time, it can lead to kidney damage, impair the excretion of metabolic wastes, and disrupt water and salt balance. Ureters are located on either side of the spine, each kidney having its own ureter, which measures approximately 22 to 30 cm before connecting to the bladder.

The obstruction can occur during fetal development, childhood, or adulthood, and may be congenital or acquired. The severity of the obstruction (partial or complete, unilateral or bilateral), the duration, the condition of the kidneys, and the presence of other factors like urinary infections all influence the impact of the condition, he noted.

One significant aspect of the ureter is that there are three natural narrow areas, which are important in cases of ureteric stones, as these stones are likely to lodge and become stuck in these areas. The obstruction can result from internal factors (within the ureter) or external compression. Causes of obstruction can be congenital, neoplastic, inflammatory, or other miscellaneous reasons.

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Dr. Raghavendra further explained that some common causes of ureteral obstruction include ureteric stones, pelvi-ureteric junction obstruction, primary tumors within or outside the ureter, and blood clots. Interestingly, stones in the ureter can cause obstruction, and obstruction from other causes can promote stone formation. Stones of varying sizes can lead to ureteral obstruction; a stone as small as 2 mm may block the ureter, while a 10 mm stone might not. The structure of the ureter also influences the development of obstruction.

Pelvi-ureteric junction obstruction is usually congenital, meaning present from birth, though it can also result from surgical procedures or be idiopathic, where the cause is unknown. It may present in childhood or later in life, often detected incidentally or during antenatal scans.

The symptoms of ureteral obstruction depend on how quickly the blockage develops. Acute obstruction is typically very symptomatic. Common symptoms include pain, particularly in the lower back or flank (between the ribs and hips), described as sharp, stabbing, or cramp-like. The pain may shift to the front of the abdomen and radiate towards the groin as the stone moves. The increased pressure in the ureter causes pain and vomiting, which may provide temporary relief. The stagnant urine can promote bacterial growth, leading to fever. Persistent vomiting and fever can result in dehydration. Hematuria, or blood in the urine, is another common symptom caused by friction between the stone and the urinary tract lining. However, the blood loss is usually minimal.

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Finally, Dr. Raghavendra emphasized that the causes and symptoms of ureteral obstruction vary significantly. No single diagnosis applies to all cases, and seeking specialist consultation is essential for accurate diagnosis and treatment.