Obstructive Anuria of Adults in the Region of Eastern Morocco: Epidemiological, Diagnosis and Therapeutic Aspects. Retrospective Two Center Study of 44 Cases

Abstract

Purpose: To analyze the aspects of obstructive anuria in adults. Materials and Methods: A two center retrospective study over a period of 4 years (2011-2014) compiled 44 patients in two urology departments in the region of eastern Morocco. Many data were collected. We studied two groups: the first group of stone formers patients (n= 16) and the second group of neoplastic patients (n= 28). A comparison between the two groups was performed. Results: The mean age was 61 years with a sex ratio of 1.3. The main symptoms were anuria (50%) and back pain (50%). The obstruction was neoplastic in 28 cases, and 16 cases of stones. A renal urine diversion performed in 11 patients (25%), either by percutaneous nephrostomy in 26 cases (59.1%) or by a double-J ureteral probe in 13 cases (29.5%). There was 3 deaths (6.8%) and 9 cases of chronic renal failure (20.45%). Discussion: To our knowledge, this is the first epidemiological and analytical study on obstructive anuria carried out in the region of eastern Morocco. Urgent diagnosis and therapeutic management are requested to prevent metabolic consequences. Helical CT scan without enhancing contrast is a promising technique for anuria’s exploration. It is indicated whenever ultrasonography and standard radiography cannot determine the cause of anuria. Antegrade opacification by the nephrostomy probe and retrograde ureteropyelography (UPR) can be helpful to visualize the nature of the obstacle and its headquarters, but these two examinations are less practiced since the advent of the CT scan. Conclusion: Obstructive anuria is an urological emergency that involves immediate and functional prognosis of the kidney. Its management is closely related to the etiology of the obstruction which also determines the prognosis.