Infected obstructed ureteric stricture — ESENeph MCQ

Correct answer: A — Give effective antibiotics and urgently drain the obstructed collecting system

The best answer is “Give effective antibiotics and urgently drain the obstructed collecting system”. Infected hydronephrosis requires source control by nephrostomy or ureteric stent plus immediate antibiotics and cultures. Definitive stricture management is planned after stabilisation. “Treat with oral analgesia while waiting for spontaneous stricture resolution” is less appropriate because infected obstruction risks sepsis and kidney loss “Perform elective reconstructive surgery before controlling infection” is less appropriate because definitive repair follows urgent drainage and sepsis treatment “Use a diuretic to force urine through the stricture” is less appropriate because increasing urine production does not relieve a fixed infected obstruction “Avoid drainage because there is no stone” is less appropriate because the emergency is infection plus obstruction, independent of its cause

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