“Obstructive uropathy and refluxuropathy” (ICD-10-GM N13.-:Obstructive uropathy and refluxuropathy) refers to urinary transport disorders (urinary stasis/urinary retention). In obstructive uropathy, urinary outflow is disturbed due to obstruction (blockage) of the urinary tract. As a result, refluxuropathy (urinary retention; urine flows back from the bladder into the kidney (reflux)) occurs.
The following conditions are grouped under this topic:
- Hydronephrosis associated with ureteropelvic obstruction (ICD-10-GM N13.0) – hydronephrosis (water-bag kidney) describes a saccular dilatation of the kidney that results from urinary outflow obstruction; in this case, the outflow obstruction is in the ureter or pelvic region
- Hydronephrosis associated with ureteral stricture, not elsewhere classified (ICD-10-GM N13.1) – outflow obstruction caused by a narrowing of the ureters (ureteral stricture)
- Hydronephrosis due to obstruction by renal and ureteral stone (ICD-10-GM N13.2) – Hydronephrosis due to obstruction of the ureter because of renal or ureteral stone.
- Other and unspecified hydronephrosis (ICD-10-GM N13.3).
- Hydroureter (ICD-10-GM N13.4) – ureteral dilatation due to urinary reflux prior to stenosis (stricture).
- Kink and stricture of the ureter without hydronephrosis (ICD-10-GM N13.5)
- Pyonephrosis (ICD-10-GM N13.6) – accumulation of pus in the renal pelvis.
- Uropathy associated with vesicoureteral reflux (ICD-10-GM N13.7) – pathological changes in the genitourinary system associated with urinary reflux from the bladder into the ureter
- Other obstructive uropathy and refluxuropathy (ICD-10-GM N13.8).
- Obstructive uropathy and refluxuropathy, unspecified (ICD-10-GM N13.9).
Obstructive uropathy is the most common congenital (congenital) abnormality of the urinary tract.
Obstructive uropathies can be classified according to the following criteria:
- Extent – complete or incomplete
- Duration – acute or chronic
- Localization of obstruction – high seated or low seated.
Refluxuropathy is classified into different degrees:
- Grade I: The reflux does not reach the renal pelvis.
- Grade II: The reflux reaches the renal pelvis
- Grade III: Dilatation (“enlargement”) of the ureter (ureter).
- Grade IV: Dilatation of the renal pelvis.
- Grade V: Impression (indentation) of the papillae.
Sex ratio: congenital obstructive uropathy affects boys more often than girls (5: 1). In the age group over 60 years, men are more often affected than women (due to prostatic hyperplasia (enlargement of the prostate) and prostatic carcinoma (prostate cancer)).
Frequency peak: The disease occurs more frequently in early childhood (congenital form) and after the age of 60 (especially in men).
The prevalence of obstructive uropathy in adults is 3.5-3.8% (in Germany).
Course and prognosis: The urinary retention caused by obstructive uropathy and refluxuropathy leads to an increased susceptibility of the urinary tract to infections. Interstitial nephritis (inflammation of the space surrounding the tubules) and increased pressure in the urinary system are common. Dilatation (widening) of the renal pelvic caliceal system (hydronephosis) occurs. Consequently, the loss of functional kidney tissue may occur. Without adequate therapy, obstructive uropathy and refluxuropathy end in nephrocirrhosis (shrunken kidney).
