Congenital uropathies, sometimes called obstructive uropathies or urinary obstruction, refer to birth defects and inherited conditions that affect urine flow. They can be structural or functional abnormalities that cause urine to back up into your kidneys. These conditions need treatment to prevent kidney failure.

Some obstructive uropathies can be diagnosed during development in the womb, but some conditions can also go unnoticed until symptoms occur in adolescence or adulthood. Congenital uropathies can affect one or both kidneys, and they can start suddenly (acute) or happen over time (chronic). They can be caused by:

• Benign prostatic hyperplasia: an enlarged prostate
• Congenital urinogenital anomalies: birth defects or hereditary conditions that affect the urinary tract and genitals
• Kidney stones: solid masses formed by minerals and substances in the urine
• Ureters or urethra malformations: defects in tubes that carry urine between your bladder and kidneys, such as posterior urethral valves, ureteropelvic junction abnormalities, or urethral atresia

Signs and symptoms of congenital obstructive uropathies include swelling, nausea, or vomiting, and problems urinating. Doctors at University of Miami Health System specialize in diagnosing and treating congenital uropathies in people of all ages. Our kidney specialists (nephrologists) work with urologists and other experts to develop a personalized treatment plan.

Tests

24-hour Volume Test
This test measures the amount of urine you produce in 24 hours. Much like a standard urinalysis, this test also looks for red blood cells, white blood cells, infections, or excessive protein in your urine.

Cystography
Bladder cystography, also called voiding cystourethrogram (VCUG) or micturating cystourethrogram (MCUG), helps doctors diagnose urethra abnormalities or urinary dysfunction, such as bladder-control problems, blockages, or urinary tract infections (UTIs). During the procedure, your bladder is filled with contrast dye and an imaging technologist takes X-rays while you urinate.

Duplex Scan
This ultrasound exam uses sound waves to allow your doctor to check the arteries in your kidney (renal arteries) and look for blockages or narrowing.

Imaging Exams
Diagnostic imaging shows kidney size and function, as well as obstructions or structural problems in your kidney or urinary tract. Doctors use ultrasound, X-ray, computed tomography (CT), and magnetic resonance imaging (MRI).

Renal Scan (Radionuclide Scan)
This nuclear imaging exam uses a small amount of radiotracer chemical that’s injected into your veins to assess your kidney’s urine production and blood flow. The imaging technologist uses a special camera (called a gamma camera or scanner) to detect the radiotracer from outside your body. Renal scans can identify reduced kidney function that’s caused by injuries, diseases, structural defects, or obstructions.

Intravenous Pyelogram (IVP)
An IVP is an X-ray that shows the kidneys, bladder, and urinary tract (ureters and urethra). It can show the size, shape, and position of your urinary tract, and help your doctor evaluate kidney function.

Treatments

Bladder Catheterization
Your doctor may use a catheter (thin, flexible tube) to drain excess urine and prevent further damage.

Dialysis
Dialysis mechanically performs the function of your kidneys. It’s not a cure for kidney disease, but it can make you feel better and live longer. There are different types of dialysis, which can take place at one of our facilities or at home. Types of dialysis include:

• Hemodialysis: This form of dialysis uses a machine, called a dialyzer, to clean your blood outside of your body. Your doctor will do a minor surgery (called dialysis access) to prepare a vein in your arm for removing and returning blood. During dialysis, blood is taken out of the access point with a needle, passed through the dialyzer, and returned to your body through a different needle. Hemodialysis treatments take a few hours and are performed a few times a week.

• Peritoneal Dialysis: This form of dialysis uses your own body to filter blood using a catheter (a thin, flexible tube) placed in your navel. In a process called an exchange, a solution is passed through the catheter into your abdomen either by hand or a machine. The solution soaks up waste and excess body fluids and returns it to a collection bag. The procedure is usually performed four or more times a day, and each exchange takes a few hours.

Hormone Therapy
Kidney disease can be associated with hyper or hypothyroidism, which impacts weight, heart rate, and body temperature, and may cause fatigue. Your doctor may recommend thyroid hormone therapy to restore a healthy balance. Doctors also use adrenocorticotropic hormone (ACTH) to treat nephrotic syndrome. ACTH releases cortisol, which helps regulate your metabolism and blood pressure.

Kidney Transplant
If dialysis or other therapies no longer work, your doctor may recommend a kidney transplant.

Surgery
In some instances, doctors perform surgery to repair damage to the urinary tract. Our surgeons use the least-invasive techniques to help you recovery more quickly. Your doctor will discuss if surgery is right for you or your child.

Why Choose UHealth?

Nationally recognized kidney care. Our kidney care program has been ranked among the nation’s best programs by U.S. News & World Report for the past nine years. We use preventive approaches to help avoid kidney injury and disease, along with advanced therapies to improve kidney health and function. We offer some of the most advanced kidney therapies, including continuous renal replacement therapy (CRRT) and therapeutic plasma exchange (TPE).

Comprehensive care in a compassionate, supportive environment. Kidney health impacts vital functions throughout your body. The kidneys can also be impacted by autoimmune or genetic disorders, which can lead to additional complications. That’s why our nephrologists work as part of a team to address the whole person. This group can include general physicians and specialists, nurses, social workers, dietitians, psychologists, and teachers.

Latest breakthroughs in clinical treatment. Our leading-edge research allows us to offer advanced approaches you won’t find nearby, including promising new therapies through clinical trials. Our academic research is supported by nationally recognized health organizations, including the National Institutes of Health (NIH), American Society of Nephrology, American Diabetes Association, and the American Heart Association.

World-class care in an academic health system. We’re recognized by the National Institutes of Diabetes and Digestive and Kidney Diseases as a Center of Excellence and a leader in treating kidney conditions. Backed by one of the nation’s top universities, our team uses the latest technologies and research-driven expertise to provide you with superior, personalized care and the latest treatment options.