Ureteral Obstruction

A ureteral obstruction is a blockage in your ureters, the tubes that carry urine from your kidneys to your bladder. Although common, a ureteral obstruction can quickly turn serious. Fast, effective treatment from the urologists at UMass Memorial Health can help you find relief and prevent dangerous health complications.  

We offer easy access to routine tests and treatment in locations close to home. For advanced care, many people turn to the highly regarded urologists at UMass Memorial Medical Center in Worcester. Our team includes the region’s only fellowship-trained urologists, some of whom are world-renowned. They deliver services reflecting the latest science in urethral obstruction care.

What Is a Urinary Tract Obstruction?  

A urinary tract obstruction is any blockage that prevents urine from flowing normally through your urinary tract — your kidneys, ureters, bladder and urethra. Since your urinary tract is how your body filters waste and excess fluid from your blood, a buildup of these substances can cause a lot of problems. 

A blockage in the ureters can cause urine to back up into the kidneys. This can lead to infection, hydronephrosis (swelling in the kidneys) or sepsis, a life-threatening condition. A ureteral obstruction can affect women and men, though it’s more common in older men. 

What Causes Ureteral Obstruction? 

A ureteral obstruction can have many causes, including: 

• Congenital (present at birth) conditions
• Injuries due to trauma or surgery
• Kidney stone disease
• Ureteral cancer, benign tumors or cysts
• Urethral stricture disease (narrowing due to scar tissue)

Obstructions can also develop when other organs press on the ureters: 

• Benign prostatic hyperplasia (enlarged prostate)
• Blood vessel abnormalities
• Gastrointestinal issues such as Crohn’s disease
• Urogynecologic disorders such as endometriosis or pelvic organ prolapse

Ureteral Obstruction Symptoms

Talk to your primary health care provider or a urologist right away if you notice symptoms of a ureteral obstruction, such as: 

• Blood in your urine
• Cloudy or bad-smelling urine
• Difficulty urinating
• Fever, nausea or vomiting
• Frequent urinary tract infections
• Pain in your lower back or abdomen
• Swelling in your legs, ankles or feet

Our Approach to Ureteral Obstruction Treatment

If you’ve been diagnosed with a ureteral obstruction or have concerning symptoms, our urologists are here to deliver a prompt diagnosis and treatment. 

Our first priority is to drain urine from your body to relieve symptoms and prevent permanent damage to your kidneys and urinary tract. These treatments usually bring temporary relief but don’t address the underlying cause of the blockage. 

Additional Treatment Options 

Addressing the common causes of urethral obstruction can provide longer-term relief. Doctors with a depth of experience at UMass Memorial Medical Center offer: 

• Ureteral stenting: We use imaging guidance to thread a stent (thin tube) through your urethra and up to the blocked ureter. The stent holds the ureter open so urine can pass.
• Nephrostomy: We make a small opening in your back and insert a catheter (flexible tube) to drain urine directly from your kidneys into an external pouch.  

Complex Urethral Reconstruction

We use evidence-based techniques offering a more permanent solution to lower your risk of future blockages. These procedures are available at UMass Memorial Medical Center and include:

• Urethroplasty: A urologist removes an area of tissue containing the blockage. They then connect the two ends or use tissue from elsewhere in your body to reconstruct the urethra.
• Bladder neck advancement: This option is for blockages near where the bladder connects to the urethra (bladder neck). Urologists reposition the neck creating a new, permanent pathway for urine to flow. Our program is among a select few in Massachusetts programs offering this option.