In studies this corresponds to higher incidences of severe neutropenia and diarrhea.In 2004, a clinical study was performed that both validated prospectively the association of the *28 variant with greater toxicity and the ability of genetic testing in predicting that toxicity before chemotherapy administration.In 2005, the FDA made changes to the labeling of irinotecan to add pharmacogenomics recommendations, such that irinotecan recipients with a homozygous (both of the two gene copies) polymorphism in UGT1A1 gene, to be specific, the *28 variant, should be considered for reduced drug doses. Irinotecan is one of the first widely used chemotherapy agents that is dosed according to the recipients genotype. Approval
Irinotecan received accelerated approval from the U.S. Food and Drug Administration (FDA) in 1996, and full approval in 1998. Names
During development, it was known as CPT-11. Formulations
A liposome encapsulated version of irinotecan sold as Onivyde by Merrimack Pharmaceuticals, was approved by FDA in October 2015, to treat metastatic pancreatic cancer. It was approved for medical use in the European Union in October 2016. See also
Etirinotecan pegol, an experimental derivative of irinotecan with a longer half-life in the human body

References
Further reading
Dean L (2015). "Irinotecan Therapy and UGT1A1 Genotype". In Pratt VM, McLeod HL, Rubinstein WS,  et al. (eds.). Medical Genetics Summaries. National Center for Biotechnology Information (NCBI). PMID 28520360. Bookshelf ID: NBK294473. External links
"Irinotecan". Drug Information Portal. U.S. National Library of Medicine. "Irinotecan hydrochloride". Drug Information Portal. U.S. National Library of Medicine. Irinotecan Pathway on PharmGKB
Urinary tract obstruction is a urologic disease consisting of a decrease in the free passage of urine through one or both ureters and/or the urethra. It is a cause of urinary retention. Complete obstruction of the urinary tract requires prompt treatment for renal preservation. Any sign of infection, such as fever and chills, in the context of obstruction to urine flow constitutes a urologic emergency. Causes
Causes of urinary tract obstruction include:

Bladder stone and renal stone
Benign prostatic hyperplasia
Obstruction as a congenital disorder. Congenital urinary tract obstruction
Urinary tract obstruction as a congenital disorder results in oligohydramnios which in turn can lead to the Potter sequence of atypical physical appearance. Pulmonary hypoplasia is by far the main cause of death in the early neonatal period for children with congenital lower urinary tract obstruction.Fetal surgery of congenital lower urinary tract obstruction seems to improve survival, according to a randomized yet small study. Sitting voiding position
A meta-analysis on the influence of voiding position on urodynamics in healthy males and males with LUTS showed that in the sitting position, the residual urine in the bladder was significantly reduced. The other parameters, namely the maximum urinary flow and the voiding time were increased and decreased respectively. For healthy males, no influence was found on these parameters, meaning that they can urinate in either position. Diagnosis
Treatment
Treatment depends on the underlying cause of the obstruction and the severity of the symptoms. References


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