Dilatation of the
calyces, renal pelvis and ureters is classically what we observe in sonography
to make the diagnosis if obstruction. In some cases, a phenomenon of non
dilated obstruction does happen where no signs of obstruction can be noted in
US or CT scans.
One of
the earlier studies had looked at a series of patients at a single center and
found that most common cause of these type of situations were cancers ( likely
RP related)- so prostate, colon, bladder, lymphomas and other series have found
cervical cancer as well. Antegrade
urography had found the obstruction in all of the cases in that one
series.
Why does it happen?- RP fibrosis can perhaps interfere with peristalsis and lead to non dilatation, RP carcinamatosis can encase the ureters and renal pelvis producing obstruction without dilatation or could this be a chronic incomplete obstruction are some suggestions based on the authors.
Treatment is usually diagnostic. Given the pathology and the cause of the
obstruction being present after an ureteral stents are placed, they usually
only temporize the treatment. Percutaneous nephrostomy is usually the best
procedure in such situations.
Here are some other studies regarding this interesting entity.
Here are some other studies regarding this interesting entity.
