uppertract

Upper tract (in medical usage) refers to the upper portion of a tubular organ system. In urology and nephrology, the term most often denotes the upper urinary tract, comprising the kidneys, renal pelvis, and ureters, as distinct from the lower urinary tract, which includes the bladder and urethra. Some descriptions also include the calyces as part of the collecting system.

The kidneys filter blood to produce urine, which drains through the calyces into the renal pelvis and onward via the ureters to the bladder. The upper tract therefore plays a key role in urine formation and transport, while maintaining fluid and electrolyte balance.

Common conditions affecting the upper tract include nephrolithiasis with stones in the renal pelvis or ureter, hydronephrosis due to obstruction, and upper tract urothelial carcinoma (UTUC) arising from the renal pelvis or ureteral lining. Infections and inflammatory disorders can involve the upper tract as well.

Diagnosis relies on imaging and endoscopic evaluation. CT urography is commonly used for detailed assessment, alongside ultrasound and MR urography. IV urography, retrograde pyelography, and ureteroscopy may be employed to evaluate structure and obtain tissue or stone samples. Laboratory tests may include renal function measures.

Management depends on the disease. Stones may be treated with shock wave lithotripsy or ureteroscopy with lithotripsy, and renal or ureteral stones larger than a few centimeters may require percutaneous nephrolithotomy. UTUC is usually managed with nephroureterectomy, often with removal of a bladder cuff; kidney-sparing approaches are considered in select cases. Obstruction may require stents or nephrostomy tubes.

The term upper tract emphasizes the anatomical location within the urinary system and is also used in other organ systems to describe proximal segments of tubiform structures.