- Experience. Mayo Clinic urologists have extensive experience in treating ureteral obstructions, including minimally invasive procedures and robot-assisted surgery as well as ureteral reconstruction of all types, depending on your need.
- Outcomes. As a high-volume center, Mayo Clinic has a long history of success using advanced procedures that improve your surgical outcomes and speed your recovery.
- Comprehensive care. Urology and kidney specialists (nephrologists) work together to diagnose and treat your condition.
- Research. Mayo Clinic researchers continue to evaluate new ways to treat ureteral obstructions.
Mayo Clinic in Rochester, Minn., ranks No. 1 for urology in the U.S. News & World Report Best Hospitals rankings. Mayo Clinic in Scottsdale, Ariz., and Mayo Clinic in Jacksonville, Fla., are ranked high performing for urology by U.S. News & World Report.
The job of the urinary system is to eliminate waste from the body. The normal urinary system consists of two kidneys, with a tube (ureter) connecting each kidney to the bladder and another tube (urethra) that drains urine from the bladder out of the body. A ureteral obstruction is a blockage that occurs anywhere in the tubes that carry urine from your kidneys to your bladder.
Certain conditions make you more likely to have a ureteral obstruction, including conditions present from birth (congenital), a tendency to make kidney stones or recent cancer surgery.
Types of ureteral obstruction
Duplication of the ureter. This common congenital condition causes two ureters to form on the same kidney. The second ureter can be normal or only partially developed. If either of these ureters doesn't function properly, urine can back up into the kidney and cause damage.
Ureteropelvic junction. This abnormality is a blockage in the connection between the kidney and ureter that stops urine flow and causes the kidney to swell and eventually stop working. This abnormality can be congenital, can develop with normal childhood growth, can result from an injury or scarring, or in rare cases, can develop from a tumor.
Ureterovesical junction. In this condition, the blockage occurs between the ureter and the bladder, causing urine to back up into the kidneys.
Ureterocele. When the ureter is too narrow and doesn't allow urine to flow normally, a tiny hernia (ureterocele) will develop, usually in the section of the ureter closest to the bladder. This hernia blocks urine flow, causing urine to back up into the kidney, which can damage the kidney.
Intrinsic or extrinsic ureteral obstruction. This condition refers to a blocked ureter by various causes inside the ureter (intrinsic) or outside the ureter (extrinsic). They might include:
- Ureteral stones
- Severe constipation, which happens primarily in children but also occurs in adults
- Cancerous and noncancerous tumors
- Internal tissue growth, such as endometriosis in females
- Long-term swelling of the ureter wall, usually due to diseases such as tuberculosis or a parasite infection called schistosomiasis
Retroperitoneal fibrosis. This rare disorder occurs when fibrous tissue grows in the area behind the abdomen. The fibers may grow due to cancers or may result from taking certain medicines used to treat migraines. The fibers encircle and block the ureters, causing urine to back up into the kidneys.
Feb. 15, 2014
- Zeidel ML, et al. Clinical manifestations and diagnosis of urinary tract obstruction and hydronephrosis. http://www.uptodate.com/home. Accessed Aug. 20, 2013.
- Taal MW, et al. Brenner & Rector's The Kidney. 9th ed. Philadelphia, Pa.: Saunders Elsevier; 2011. http://www.clinicalkey.com. Accessed Aug. 20, 2013.
- DiMarco DS, et al. Long-term success of antegrade endopyelotomy compared with pyeloplasty at a single institution. Journal of Endourology. 2006;20:707.
- Iwaszko MR, et al. Transureteroureterostomy revisited: Long-term surgical outcomes. The Journal of Urology. 2010;183:1055.
- Knoedler J, et al. Population-based comparison of laparoscopic and open pyeloplasty in paediatric pelvi-ureretic junction obstruction. BJU International. 2013;111:1141.
- Lightner DJ (expert opinion). Mayo Clinic, Rochester, Minn. Sept. 3, 2013.
- Castle EP (expert opinion). Mayo Clinic, Phoenix/Scottsdale, Ariz. Sept. 23, 2013.