{"id":58337,"date":"2024-07-06T04:47:48","date_gmt":"2024-07-06T04:47:48","guid":{"rendered":"https:\/\/www.homeobook.com\/?p=58337"},"modified":"2024-07-06T04:47:48","modified_gmt":"2024-07-06T04:47:48","slug":"early-detection-of-obstructive-uropathy-homoeopathic-approach","status":"publish","type":"post","link":"https:\/\/www.homeobook.com\/early-detection-of-obstructive-uropathy-homoeopathic-approach\/","title":{"rendered":"Early detection of Obstructive Uropathy &#038; Homoeopathic approach"},"content":{"rendered":"<p><strong>Dr\u00a0 Sakshi<\/strong><\/p>\n<p><strong>Abstract<\/strong><br \/>\nSevere cases of lower urinary\u00a0 tract\u00a0 obstruction\u00a0 occur\u00a0 in\u00a0 the\u00a0 first\u00a0 few\u00a0 months\u00a0 of\u00a0 life, where\u00a0 as\u00a0 milder\u00a0 cases\u00a0 are\u00a0 discovered\u00a0 in\u00a0 late\u00a0 infancy\u00a0 and\u00a0 childhood.\u00a0 Obstructive\u00a0 uropathy\u00a0 should\u00a0 be\u00a0 treated\u00a0 as\u00a0 an\u00a0 emergency\u00a0 and\u00a0 prompt\u00a0 action\u00a0 is\u00a0 needed.\u00a0 To\u00a0 determine\u00a0 its\u00a0 etiology\u00a0 and\u00a0 to\u00a0 begin\u00a0 therapy\u00a0 of\u00a0 all\u00a0 renal\u00a0 developmental\u00a0 abnormalities.\u00a0 The\u00a0 best\u00a0 chance\u00a0 of\u00a0 preventing\u00a0 further\u00a0 renal\u00a0 damage\u00a0 and\u00a0 maintaining\u00a0 the\u00a0 infants\u00a0\u00a0\u00a0 survival\u00a0 is\u00a0 early\u00a0 detection\u00a0 and\u00a0 treatment\u00a0 of\u00a0 urinary\u00a0 tract\u00a0 anomalies.\u00a0 A\u00a0 common\u00a0 cause\u00a0 of\u00a0 renal\u00a0 failure\u00a0 obstructive\u00a0 uropathy which accounts for\u00a0 16.5%\u00a0 of\u00a0 paediatric\u00a0 renal\u00a0 transplants\u00a0 in\u00a0 1997.<\/p>\n<p>Key words:\u00a0 obstructive uropathy, renal calculi, UTI<\/p>\n<p><strong>Introduction<\/strong>:<br \/>\nAny\u00a0 structural\/functional\u00a0 obstruction\u00a0 to\u00a0 the\u00a0 regular\u00a0 flow\u00a0 of\u00a0 urine\u00a0 is\u00a0 known\u00a0 as\u00a0 obstructive\u00a0 uropathy.\u00a0 Developmental\u00a0 obstruction\u00a0 of\u00a0 the\u00a0 urinary\u00a0 tract\u00a0 produces\u00a0 dilatation\u00a0 above\u00a0 the\u00a0 site\u00a0 of\u00a0 lesion\u00a0 and\u00a0 a\u00a0 retrograde\u00a0 rise\u00a0 in\u00a0 hydrostatic\u00a0 pressure\u00a0 causing\u00a0 structural\u00a0 and\u00a0 functional\u00a0 damage\u00a0 to\u00a0 the\u00a0 kidney.\u00a0 Depending\u00a0 on\u00a0 the\u00a0 cause,\u00a0 the\u00a0 prevalence\u00a0 of\u00a0 obstructive\u00a0 uropathy\u00a0 varies\u00a0 from\u00a0 5\u00a0 in\u00a0 10000 to 5\u00a0 in\u00a0 1000.\u00a0 In\u00a0 children,\u00a0 it\u00a0 is\u00a0 mostly\u00a0 caused\u00a0 by\u00a0 congenital\u00a0 abnormalities\u00a0 of\u00a0 the\u00a0 urinary\u00a0 tract.\u00a0 In\u00a0 young\u00a0 adults\u00a0 calculi\u00a0 is\u00a0 main\u00a0 cause.\u00a0 Associated\u00a0 UTI\u00a0 which\u00a0 should\u00a0 be\u00a0 identified\u00a0 and\u00a0 managed\u00a0 obstructive\u00a0 uropathy\u00a0 is\u00a0 an\u00a0 important\u00a0 cause\u00a0 of\u00a0 end\u00a0 stage\u00a0 renal\u00a0 disease.<\/p>\n<p><strong>Etiology\u00a0 and\u00a0 pathophysiology<\/strong>:\u00a0 Obstructive\u00a0 lesions\u00a0 of\u00a0 urinary\u00a0 tract\u00a0 that\u00a0 is\u00a0 the\u00a0 pelvis,\u00a0 ureter,\u00a0 bladder,\u00a0 or\u00a0 urethra,\u00a0 obstruction\u00a0 can\u00a0 be\u00a0 congenital\/acquired\u00a0 obstruction. It may\u00a0 be\u00a0 partial\u00a0 or\u00a0 complete.<\/p>\n<p><strong>Common\u00a0 causes:<\/strong><br \/>\nRenal\u00a0 calculi,\u00a0 blood\u00a0 clots,\u00a0 congenital\u00a0 anomalies,\u00a0 tumors,\u00a0 urethral\u00a0 strictures,\u00a0 ureterocele,\u00a0 urolithiasis,\u00a0 phimosis\/paraphimosis,\u00a0 parasitic\u00a0 obstructions,\u00a0 neuropathic\u00a0 bladder\u00a0 dys-\u00a0 function,\u00a0 retroperitoneal\u00a0 adenopathy,\u00a0 bladder\u00a0 endometriosis.<\/p>\n<p><strong>Common\u00a0 obstructive\u00a0 lesions<\/strong><\/p>\n<ul>\n<li>-pelviureteric\u00a0 junction<\/li>\n<li>-calculi\u00a0 in\u00a0 pelvis,\u00a0 ureter\/urinary\u00a0 bladder<\/li>\n<li>-diverticuli\u00a0 \/ureteroculy<\/li>\n<li>-posterior\u00a0 urethral\u00a0 valves<\/li>\n<li>-bladder\u00a0 neck\u00a0 obstruction<\/li>\n<li>-phimosis,\u00a0 paraphimosis,\u00a0 meatal\u00a0 stenosis<\/li>\n<li>-neurogenic\u00a0 bladder<\/li>\n<\/ul>\n<p>The\u00a0 increase\u00a0 in\u00a0 ureteric\u00a0 pressure \u00a0is\u00a0 transmitted\u00a0 to\u00a0 renal\u00a0 pelvis\u00a0 and\u00a0 tubules,\u00a0 causing\u00a0 a\u00a0 fall\u00a0 in\u00a0 GFR\u00a0 the\u00a0 mechanical\u00a0 effort\u00a0 of\u00a0 high\u00a0 pressure\u00a0 on\u00a0 the\u00a0 urethras\u00a0 and\u00a0 pelvicalyceal\u00a0 result\u00a0 in\u00a0 their\u00a0 dialatation\u00a0 tortuorsity\u00a0 and\u00a0 loss\u00a0 of\u00a0 peristalasis\u00a0 there\u00a0 is\u00a0 impairment\u00a0 of\u00a0 tubular\u00a0 function\u00a0 characterized\u00a0 by\u00a0 disease,\u00a0 ability\u00a0 to\u00a0 concentrate\u00a0 and\u00a0 acidify\u00a0 urine,\u00a0 dicrease\u00a0 in\u00a0 the\u00a0 potassium\u00a0 excretion\u00a0 and\u00a0 reduce\u00a0 a\u00a0 responsiveness\u00a0 to\u00a0 ADH.\u00a0 These\u00a0 abnormalities\u00a0 lead\u00a0 to\u00a0 polyuria,\u00a0 hyperkalemia,\u00a0 hyperchloride,\u00a0 metabolic\u00a0 acidosis,\u00a0 high\u00a0 urine\u00a0 pH.\u00a0 Obstruction\u00a0 below\u00a0 the\u00a0 level\u00a0 of\u00a0 bladder\u00a0 results\u00a0 in\u00a0 distension\u00a0 of\u00a0 the\u00a0 bladder\u00a0 with\u00a0 thickened\u00a0 walls.\u00a0 Due\u00a0 to\u00a0 poor\u00a0 emptying\u00a0 stagnantion\u00a0 of\u00a0 urine\u00a0 occurs\u00a0 which\u00a0 predispose\u00a0 to\u00a0 infection\u00a0 and\u00a0 stone\u00a0 formation.\u00a0 Disease\u00a0 of\u00a0 spinal\u00a0 cord\u00a0 like\u00a0 meningomyelocele,\u00a0 lypomengiocele,\u00a0 tethered\u00a0 cord\u00a0 can\u00a0 lead\u00a0 to\u00a0 functional\u00a0 obstruction\u00a0 due\u00a0 to\u00a0 detrusor,\u00a0 sphincter\u00a0 dyssynergia.<\/p>\n<p><strong>Clinical\u00a0 features<\/strong>:<br \/>\nDistension\u00a0 of\u00a0 abdomen,\u00a0 poor\u00a0 urinary\u00a0 stream,\u00a0 distended\u00a0 firm\u00a0 bladder,\u00a0 excessive\u00a0 crying,\u00a0 irritability,\u00a0 poor\u00a0 feeding,\u00a0 occasionally\u00a0 hematuria.\u00a0 Older\u00a0 children\u00a0 may\u00a0 present with abdominal\u00a0 pain,\u00a0 straining,\u00a0 dribbling,\u00a0 daytime\u00a0 enuresis,\u00a0 polyuria,\u00a0 frequency,\u00a0 UTI.<\/p>\n<p><strong>Investigation<\/strong>:\u00a0 Antenatal\u00a0 sonography\u00a0 at\u00a0 16-18weeks,\u00a0 24-26\u00a0 and\u00a0 30-32weeks,<\/p>\n<p>USG\u00a0 findings-\u00a0 dilation\u00a0 of\u00a0 the\u00a0 pelvicalyceal\u00a0 system,\u00a0 ureters\u00a0 and\u00a0 bladder,\u00a0 hydronephrosis,\u00a0 cortical\u00a0 thickness\u00a0 and\u00a0 scarring.<\/p>\n<p>MCU-\u00a0 micturating\u00a0 cycto-urethrogram-\u00a0 detect\u00a0 posterior\u00a0 urethral\u00a0 valves.<\/p>\n<p>DDU-duplex\u00a0 doppler\u00a0 ultrasonography-\u00a0 can\u00a0 show\u00a0 unilateral\u00a0 obstruction\u00a0 in\u00a0 the\u00a0 1<sup>st<\/sup>\u00a0 few\u00a0 days\u00a0 of\u00a0 acute\u00a0 obstruction.<\/p>\n<p>Antegrade\u00a0 pyelogram-\u00a0 rarely\u00a0 necessary,\u00a0 helpful\u00a0 in\u00a0 some\u00a0 confusing\u00a0 cases,\u00a0 when\u00a0 there\u00a0 is\u00a0 a\u00a0 doubt\u00a0 about\u00a0 the\u00a0 exact\u00a0 level\u00a0 of\u00a0 obstruction.<\/p>\n<p>Functional\u00a0 renal\u00a0 imaging\u00a0 ,\u00a0 most\u00a0 commonly\u00a0 with\u00a0 MAG\u00a0 3\u00a0 nuclear\u00a0 medicine\u00a0 renal\u00a0 scan\u00a0 ,\u00a0 is\u00a0 recommended\u00a0 in\u00a0 evaluation\u00a0 of\u00a0 children\u00a0 with\u00a0 urinary\u00a0 tract\u00a0 dilation\u00a0 suspicious\u00a0 for\u00a0 obstructive\u00a0 uropathy.\u00a0 Focused\u00a0 emergency\u00a0 renal\u00a0 sonography\u00a0 facilitates\u00a0 accurate\u00a0 diagnosis\u00a0 of\u00a0 obstructive\u00a0 uropathy.\u00a0 Helps\u00a0 rule\u00a0 out,\u00a0 more\u00a0 dangerous\u00a0 pathology,\u00a0 is\u00a0 safe\u00a0 for\u00a0 pregnant\u00a0 patients\u00a0 and\u00a0 children,\u00a0 requires\u00a0 less\u00a0 radiation\u00a0 than\u00a0 CT\u00a0 scan.<\/p>\n<p><strong>Management:\u00a0 homoeopathic\u00a0 approach<br \/>\n<\/strong>Homoeopathic\u00a0 medicines\u00a0 are\u00a0 very\u00a0 beneficial\u00a0 in\u00a0 treating\u00a0 the\u00a0 UTI\u00a0 and\u00a0 prevent\u00a0 the\u00a0 child\u00a0 from\u00a0 recurrent\u00a0 infections.<\/p>\n<p>1.Apis\u00a0 mel:<\/p>\n<ul>\n<li>-burning\u00a0 sensation\u00a0 passing\u00a0 the\u00a0 last\u00a0 drop\u00a0 of\u00a0 urine<\/li>\n<li>-increased\u00a0 frequency<\/li>\n<li>-itching\u00a0 of\u00a0 urethra<\/li>\n<\/ul>\n<p>2.Sarsaparilla:<\/p>\n<ul>\n<li>-urging\u00a0 to\u00a0 urinate<\/li>\n<li>-child\u00a0 pass\u00a0 urine\u00a0 only\u00a0 while\u00a0 standing<\/li>\n<li>-urine\u00a0 passes\u00a0 in\u00a0 thin\u00a0 stream<\/li>\n<li>-pain\u00a0 at\u00a0 the\u00a0 end\u00a0 of\u00a0 urination<\/li>\n<li>-involuntary\u00a0 urination\u00a0 at\u00a0 night<\/li>\n<\/ul>\n<p>3.Nux\u00a0 vomica:<\/p>\n<ul>\n<li>-passing\u00a0 small\u00a0 amount\u00a0 of\u00a0 urine<\/li>\n<li>-irritable\u00a0 child<\/li>\n<li>-impatient<\/li>\n<\/ul>\n<p>4.Berberis\u00a0 vulg:<\/p>\n<ul>\n<li>-burning\u00a0 sensation\u00a0 while\u00a0 passing\u00a0 urine<\/li>\n<li>-urging\u00a0 and\u00a0 discomfort<\/li>\n<li>-Cystitis<\/li>\n<\/ul>\n<p>5.Borax:<\/p>\n<ul>\n<li>-UTI\u00a0 in\u00a0 children<\/li>\n<li>-Foul\u00a0 smell\u00a0 urine<\/li>\n<li>-child\u00a0 cries\/screams\u00a0 before\u00a0 passing\u00a0 out\u00a0 of\u00a0 pain<\/li>\n<li>-increased\u00a0 frequency<\/li>\n<\/ul>\n<p>6.Lycopodium\u00a0 clav:<\/p>\n<ul>\n<li>-pale\u00a0 color\u00a0 urine<\/li>\n<li>-foul\u00a0 smelling\u00a0 sediments<\/li>\n<li>-child\u00a0 cries\u00a0 before\u00a0 passing\u00a0 urine<\/li>\n<li>-Involuntary\u00a0 urination<\/li>\n<\/ul>\n<p><strong>Conclusion:\u00a0 <\/strong>Facilities\u00a0 for\u00a0 early\u00a0 detection\u00a0 and\u00a0 treatment\u00a0 of\u00a0 obstructive\u00a0 uropathy\u00a0 in\u00a0 our\u00a0 environment\u00a0 are\u00a0 urgently\u00a0 required.\u00a0 Homoeopathic\u00a0 medicines\u00a0 are\u00a0 very\u00a0 beneficial\u00a0 in\u00a0 treating\u00a0 the\u00a0 urinary\u00a0 complaints\u00a0 and\u00a0 prevent\u00a0 the\u00a0 child\u00a0 from\u00a0 recurring\u00a0 infections.\u00a0 Long-term\u00a0 follow-ups\u00a0 necessary\u00a0 to\u00a0 look\u00a0 for\u00a0 UTI\u00a0 and\u00a0 treat\u00a0 associated\u00a0 complications.\u00a0 Renal\u00a0 dysplasia\u00a0 and\u00a0 renal\u00a0 scars\u00a0 already\u00a0 present\u00a0 before\u00a0 the\u00a0 relief\u00a0 of\u00a0 obstruction\u00a0 may\u00a0 eventually\u00a0 lead\u00a0 to end stage renal disease (ESRD)\u00a0 over\u00a0 a\u00a0 period\u00a0 of\u00a0 10-15years.\u00a0 Early\u00a0 detection\u00a0 and\u00a0 intervention\u00a0 is\u00a0 very\u00a0 helpful\u00a0 to\u00a0 prevent\u00a0 permanent\u00a0 damage\u00a0 to\u00a0 kidney.<\/p>\n<p>Reference:<\/p>\n<ol>\n<li>1.Roth\u00a0 KS,\u00a0 Koo\u00a0 HP,\u00a0 Spottswood\u00a0 SE,\u00a0 Chan\u00a0 JC.\u00a0 Obstructive\u00a0 uropathy:\u00a0 an\u00a0 important\u00a0 cause\u00a0 of\u00a0 chronic\u00a0 renal\u00a0 failure\u00a0 in\u00a0 children.\u00a0 Clin\u00a0 Pediatr\u00a0 (Phila).\u00a0 2002\u00a0 Jun;41(5):309-14.\u00a0 doi:\u00a0 10.1177\/000992280204100503.\u00a0 PMID:\u00a0 12086196.<\/li>\n<li>Radmayr C.\u00a0 Congenital\u00a0 obstructive\u00a0 uropathy\u2013Diagnostics\u00a0 for\u00a0 optimal\u00a0 treatment.\u00a0 African\u00a0 Journal\u00a0 of\u00a0 Urology.\u00a0 2015\u00a0 Jun\u00a0 1;21(2):87-95.<\/li>\n<li>BHAT, S.\u00a0 R.\u00a0 (2022).\u00a0 Achar&#8217;s\u00a0 Textbook\u00a0 of\u00a0 Pediatrics.\u00a0 India:\u00a0 Orient\u00a0 Blackswan\u00a0 Pvt\u00a0 Limited.<\/li>\n<li>Gupta,\u00a0 P.,\u00a0 Menon,\u00a0 P.,\u00a0 Ramji,\u00a0 S.,\u00a0 Lodha,\u00a0 R.\u00a0 (2015).\u00a0 PG\u00a0 Textbook\u00a0 of\u00a0 Pediatrics:\u00a0 Volume\u00a0 3:\u00a0 Systemic\u00a0 Disorders\u00a0 and\u00a0 Social\u00a0 Pediatrics.\u00a0 India:\u00a0 Jaypee\u00a0 Brothers\u00a0 Medical\u00a0 Publishers\u00a0 Pvt.\u00a0 Limited.<\/li>\n<li>Parthasarathy, A.\u00a0 (2016).\u00a0 IAP\u00a0 Textbook\u00a0 of\u00a0 Pediatrics.\u00a0 India:\u00a0 Jaypee\u00a0 Brothers\u00a0 Medical\u00a0 Publishers\u00a0 Pvt.\u00a0 Limited.<\/li>\n<\/ol>\n<p><strong>Dr\u00a0 Sakshi.\u00a0<\/strong><br \/>\nPG\u00a0 Scholar,\u00a0 Department\u00a0 of\u00a0 Pediatrics<br \/>\nFather\u00a0 Muller\u00a0 Homoeopathic\u00a0 Medical\u00a0 College\u00a0 and\u00a0 Hospital\u00a0 Deralakatte,\u00a0 Mangaluru.<br \/>\nUnder the guidance of Prof.\u00a0 <strong>Dr Jyoshna Shiavprasad<\/strong>, HOD, Pediatrics<\/p>\n","protected":false},"excerpt":{"rendered":"<div class=\"mh-excerpt\"><p>Dr\u00a0 Sakshi Abstract Severe cases of lower urinary\u00a0 tract\u00a0 obstruction\u00a0 occur\u00a0 in\u00a0 the\u00a0 first\u00a0 few\u00a0 months\u00a0 of\u00a0 life, where\u00a0 as\u00a0 milder\u00a0 cases\u00a0 are\u00a0 discovered\u00a0 in\u00a0 late\u00a0 infancy\u00a0 and\u00a0 childhood.\u00a0 Obstructive\u00a0 uropathy\u00a0 should\u00a0 be\u00a0 treated\u00a0 as\u00a0 <a class=\"mh-excerpt-more\" href=\"https:\/\/www.homeobook.com\/early-detection-of-obstructive-uropathy-homoeopathic-approach\/\" title=\"Early detection of Obstructive Uropathy &#038; Homoeopathic approach\">[&#8230;]<\/a><\/p>\n<\/div>","protected":false},"author":1,"featured_media":43016,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[107],"tags":[12736],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v23.0 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Early detection of Obstructive Uropathy &amp; Homoeopathic approach<\/title>\n<meta name=\"description\" content=\"Early detection and intervention is very helpful to prevent permanent damage to kidney.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.homeobook.com\/early-detection-of-obstructive-uropathy-homoeopathic-approach\/\" \/>\n<meta property=\"og:locale\" content=\"en_GB\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Early detection of 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