Editing Management of Upper Urinary Tract Obstruction (section)

==== Benign ====

* '''<span style="color:#0000ff">SIIRRII PUF (8):</span>'''
# '''<span style="color:#0000ff">S</span><span style="color:#ff0000">tones</span>'''
# '''<span style="color:#0000ff">I</span><span style="color:#ff0000">nstrumentation, endoscopic</span>'''
# '''<span style="color:#0000ff">I</span><span style="color:#ff0000">nfection (tuberculosis)</span>'''
# '''<span style="color:#0000ff">R</span><span style="color:#ff0000">enal ablation injury</span>'''
# '''<span style="color:#0000ff">R</span><span style="color:#ff0000">adiation</span>'''
# '''<span style="color:#0000ff">I</span><span style="color:#ff0000">schemia</span>''' (trauma, surgical dissection)
# '''<span style="color:#0000ff">I</span><span style="color:#ff0000">diopathic</span>'''
# '''<span style="color:#0000ff">P</span><span style="color:#ff0000">eri</span><span style="color:#0000ff">U<span style="color:#ff0000">reteral </span><span style="color:#0000ff">F<span style="color:#ff0000">ibrosis caused by abdominal aortic aneurysm or endometriosis</span>'''
#* Endometeriosis
#** Most patients with ureteral obstruction associated with endometriosis are asymptomatic
#*** Signs and symptoms may occur cyclically and include flank pain, dysuria, urgency, hematuria and frequent urinary tract infections.
#** Management
#*** A trial of hormonal therapy using gonadotropin-releasing hormone agonists (Lupron) or medroxyprogesterone (Danazol) should be initiated for mild symptomatic obstruction when there is good preservation of renal function.
#*** For more severe obstruction associated with significant periureteral fibrosis, surgical intervention to correct the obstruction, with or without hysterectomy and bilateral salpingo-oophorectomy, is recommended
* '''Hysterectomy accounts for over 50% of iatrogenic ureteral injuries'''
** Most likely areas where the ureter can be occluded during hysterectomy (2):
**# Level of the broad ligaments
**# At the vaginal cuff and bladder trigone