Obstructive Uropathy

Urine normally travels from the renal calyces through the renal pelvis, ureters, bladder, and urethra. Obstructive uropathy occurs when a structural or functional blockage interrupts that pathway. Urine backs up, pressure rises above the blockage, and filtration falls. The result may be localized hydronephrosis, urinary retention, acute kidney injury, infection, or permanent loss of renal function if decompression is delayed. For the practical nurse, the first clinical distinction is retention versus true anuria. A patient with retention has urine trapped in an overfilled bladder; a patient with anuria is producing little or no urine, often because of bilateral upper-tract obstruction, a solitary obstructed kidney, or severe renal hypoperfusion. The nursing response begins with focused assessment, a bladder scan when appropriate, accurate output measurement, and prompt escalation within state scope, employer policy, and the nurse's demonstrated competence.