Etiology of symptomatic upper urinary tract obstruction in southeast Nigeria

Abstract

Background: The causes of upper urinary tract (UUT) obstruction vary from one geographical location to another, and across gender and age. Similarly, the site of obstruction along the ureter varies with the nature of the obstructing lesion. Data in this regard from southeast Nigeria are deficient. Objective: To determine the causes of symptomatic UUT obstruction in southeast Nigeria. Materials and Methods: The medical records of individuals with confirmed UUT obstruction presenting from January 2011 to November 2017 were reviewed for information on the cause and location of obstruction. In addition, the pattern of the obstructions caused by UUT stones was compared across the gender and age of individuals. All statistical analyses were done using SPSS® version 21. Results: The medical reports of 267 individuals are included for analysis. Overall, urinary stone is the most prevalent cause of UUT obstruction, with a male-to-female ratio of 1.25. From 50 years of age onward, obstructing UUT stones are commoner in females (χ2 = 5.03; P = 0.03). In addition, obstructing UUT stones are more common on the right (55.1%) and in the upper ureter (48.9%) in univariate analyses. Congenital pelvi-ureteric junction (PUJ) obstruction is observed to be the most prevalent congenital cause of UUT obstruction. Uterine fibroids in females and advanced prostate cancer in males are also notable causes of ureteric obstruction. Conclusion: Beyond urinary stone and congenitally defective PUJ, uterine fibroids and prostate cancer are other notable causes of ureteric obstruction in southeast Nigeria.