Medical and Surgical Management of Ureteral Obstructions

Many patients with ureteral obstructions are critically ill at the time of diagnosis, especially if there is dysfunction of the contralateral kidney. They may present with varying severities of uremia and acute kidney injury as well as systemic inflammation and sepsis secondary to infection. Medical management, which may consist of rehydration and restoration of intravascular volume with intravenous fluid therapy, osmotic diuresis, ureteral muscle relaxation, and antimicrobials for infection, is important in ureteral obstruction patients. Unstable patients may require more emergent intervention to relive the obstruction and address the life-threatening sequelae to acute kidney injury.