The most common cause of chronic bilateral obstructive uropathy is a condition called bladder outlet obstruction. The kidneys produce urine in the normal manner but the urine cannot leave the bladder. Urine backs up, causing kidney swelling and damage.
When the blockage causes urine to back up into both kidneys, hydronephrosis (swelling of the kidneys) results. High blood pressure and kidney failure can result.
In men, chronic bilateral obstructive uropathy is most often a result a result of enlargement of the prostate, also called benign prostatic hyperplasia (BPH).
Other causes of chronic bilateral obstructive uropathy include:
Bilateral uretal stones
Tumors or masses of the uterus or other structures around the bladder neck or urethra
Patients with a chronic blockage are at a higher risk for complications following initial catheter placement. During the first few days following correction of the obstruction, the kidneys may be unable to concentrate urine. As a result, your body removes large amounts of urine that haven't been properly processed. This is called post-obstructive diuresis. It can be a life-threatening condition. Close monitoring is required.
If the obstruction was caused by cancer, the ultimate outcome depends on the disease severity and your response to treatment.
Linda J. Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington, School of Medicine; Scott Miller, MD, Urologist in private practice in Atlanta, Georgia. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.