Features of the obstructive uropathy:
(1) ureteral stenoses secondary to strictures
(2) functional ureteral obstruction with aperistalsis secondary to extensive transmural fibrosis
(3) variable lithiasis
(4) bladder dysfunction
The severity of uropathy parallels the tissue egg burden.
Consequences of the obstructive uropathy:
(1) hydroureter, which may be classified as
(1a) segmental with minimally dilated, thick-walled ureters, usually involving the lower ureter, with fibrosis and sandy patches
(1b) tonic, with dilated, tortuous, thick-walled ureters and hypertrophic ureteral muscle
(1c) atonic, with dilated, tortuous, thin-walled ureters and atrophic ureteral muscle
(2) hydronephrosis
(3) deterioration in renal function, eventually leading to renal failure
Aggressive therapy, both medical and surgical, can restore renal function, even in advanced cases.
