Pattern of presentation and management of benign upper urinary tract obstruction in Sokoto Northwest Nigeria

Abstract

Background: Upper urinary tract obstruction is a common cause of severe symptoms, recurrent urinary tract infection and deterioration or complete loss of renal function when intervention is not timely.

Objective: To document the pattern of presentation and the management options for the benign upper urinary tract obstruction in our practice.

Materials and Methods: The study retrospectively reviewed patients managed for benign upper urinary tract obstruction in our facility from February 2011 to February 2016. A total of 52 patients were treated during the study period. All the patients with benign upper urinary tract obstruction were included in the study. While Patients with lower urinary tract obstruction without secondary vesico-ureteric reflux (VUR), upper urinary tract obstruction from malignancy and those with incomplete records were excluded.

Data was collected via a proforma and analysis was done using SPSS 20.0 version

Results: The mean age of patients in the study was 32.9±12.8 years and Male: female ratio was 3.3:1. The mode of presentations were flank pain in 47 patients (90.2%), haematuria in 36 patients (69.2%), childhood haematuria in 23 patients (44.2%) and urinary tract infection (UTI) in19 patients (36.5 %). The causes of upper tract obstruction were urolithiasis in 32 patients (61.6%), ureteric obstruction in 15 patients (28.8 %) and pelvi-ureteric junction obstruction in 5 patients (9.6 %). The definitive treatments were open in 27 patients (51.9 %), endoscopic in 14 patients (26.9%), and non-operative in 11 patients (21.2%).

Conclusion: Urolithiasis, ureteric obstruction and pelvi-ureteric junction obstruction are the commonest cause of benign upper tract obstruction in our environment. Treatment can be open, endoscopic or medical.

Keywords: Ureteric obstruction, urolithiasis, pelvi-ureteric junction obstruction