Causes of Urinary Tract Obstruction - Differential Diagnosis Algorithm

Upper Tract - Bladder NOT distended on ultrasound, Hematuria, flank pain, +/- N/V

 - Mass

      • Urothelial cell carcinoma

      • Squamous cell carcinoma

 - Stone

      • Calcium oxalate

      • Calcium phosphate

      • Uric acid [radiolucent on x-ray]

      • Struvite

      • Cysteine

 - Extraluminal

      • Retroperitoneal Fibrosis

      • Cancer

 - Intramural

      • Ureteropelvic junction obstruction

Lower Tract - Distended bladder on ultrasound, Urgency, frequency, hesitancy, nocturia

 - Bladder

      • Carcinoma (until proven otherwise)

      • Bladder stone

      • Thrombus (frank hematuria)

 - Outflow Tract

      • BPH

      • Prostate cancer

      • Urethral stricture

      • Posterior Urethral valves



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