Solitary Kidney Obstructing Stone — ESENeph MCQ

Correct answer: B — Urgent decompression of the solitary functioning kidney

The best answer is “Urgent decompression of the solitary functioning kidney”. A solitary obstructed kidney with anuria or declining function is a urological emergency even without sepsis. Drainage by stent or nephrostomy, or urgent definitive treatment when appropriate, restores urine flow. “Routine outpatient review in 6 weeks” is less appropriate because anuria and loss of function make delay unsafe “Increase fluid intake without assessing obstruction” is less appropriate because forced fluid cannot overcome complete obstruction and may worsen pain “Treat with antibiotics alone despite no infection and no drainage” is less appropriate because antibiotics do not relieve mechanical obstruction “Wait until permanent kidney failure is established” is less appropriate because the goal is to prevent irreversible loss of the remaining kidney

Reference: EAU 2026 urolithiasis guideline: https://uroweb.org/guidelines/urolithiasis/chapter/guidelines