Which finding most strongly suggests obstructive uropathy due to urethral stricture requiring intervention?

• A. Normal BUN/Creatinine
• B. Adequate urine flow
• C. No urinary hesitancy
• D. Difficulty voiding with elevated BUN/Creatinine

Answer: (D)

Obstructive uropathy progresses when urine outflow is blocked, creating back-pressure that can injure the kidneys. When the cause is a urethral stricture, the obstruction often presents with symptoms of difficulty voiding and, if the obstruction is significant, signs of renal impairment such as elevated BUN and creatinine. This combination—trouble starting or maintaining a stream plus rising kidney markers—strongly signals that the obstruction is clinically relevant and likely needs intervention to relieve the blockage.

If BUN and creatinine are normal, or if there is adequate urine flow, or if there is no hesitancy to void, these findings argue against a significant obstructive process that would require urgent intervention.