Obstructive Uropathy Caused by Chronic Constipation

Abstract

We herein report a case regarding a 90-year-old woman with a history of recurrent episodes of urinary tract infections presenting with fever. Urinalysis revealed bacteria and white blood cells. Computed tomography showed dilated and fecally loaded rectum and colon with signs of obstructive uropathy. The patient was treated for urinary tract infection and constipation. Her bowel habits were controlled with lubiprostone, and she was discharged in good medical condition. This case highlights the importance of considering fecal impaction as a cause of urinary tract obstruction or infection.

Opioid-Induced Constipation

“…Physicians have not long recognized many adverse effects, including OIC, with long‐term opioid administration , and patients may resist discussing their bowel habits with healthcare providers. However, it is important to facilitate such discussion, because a number of complications and adverse effects can occur with OIC, including dyspepsia, reflux, bloating, spasm, cramping , fecal impaction , urinary obstruction or infection , pain, hospitalizations, lessened quality of life, and interference with the pain treatment regimen .…”

Postrenal Acute Renal Failure Due to Giant Fecaloma-related Bilateral Hydronephrosis: A Case Report and Brief Literature Review

“…The risk factors in our case were advanced age and a history of recurrent constipation. In terms of the frequency of the disease, there is no significant difference in the ratio of women and men [4]. Usual fecaloma-related complications are intestinal obstruction, colonic ulceration, and stercoral perforation [4].…”

“…In terms of the frequency of the disease, there is no significant difference in the ratio of women and men [4]. Usual fecaloma-related complications are intestinal obstruction, colonic ulceration, and stercoral perforation [4]. The urinary system can also be rarely affected due to the local pelvic mass effect.…”

“…The most common level of obstruction is the urethra or urethral-vesical junction. The mechanism of urinary retention caused by fecal impaction is believed to be a significant elevation of the floor of the bladder and posterior urethra with resultant obstruction of the bladder outlet [4]. Thus, intravesical ureters may be pressurized, and unilateral or bilateral hydronephrosis may occur [4,6].…”

“…Although conservative methods such as the use of enemas, laxatives, and rectal evacuation are among the treatment options to relieve the fecal effect, surgical intervention is another option when these methods fail [2]. Rare cases of fecalomarelated urinary system obstruction and renal failure have also been reported [1,3,4].…”