Ureter

  • Urolithiasis
  • The ureter is a pair of hollow tubular organ through which urine from the renal pelvis enters the bladder.

    the topography of the ureter
    The topography of the ureter: 1 - left adrenal gland; 2 - the left kidney; 3 - left ureter; 4 - abdominal aorta; 5 - greater psoas muscle; 6 - the left common iliac artery and vein; 7 - the left of the internal iliac artery and vein; 8 - the left external iliac artery and vein; 9 - bladder; 10 - rectum; 11 - right ureter; 12 - the lower hollow vein; 13 - the right kidney.

    The length of the ureter 25-30 cm, it lies retroperitoneal, starts from the lower section of the renal pelvis, goes down, it goes in the small pelvis, forming the curvature of the bulge outwards into the bladder on the lower surface, oblique probada its wall (Fig.). Opens in a bubble mouth; the mouths of two ureters form the top corners of the cystic triangle.
    The ureter is conventionally divided into three sections: abdominal - from the pelvis to the entrance to the pelvis, pelvic - up to the bladder and intramural - in length of 1,5-2 cm behind the wall of the bladder. The diameter of the ureter 4-15 mm Ureter has three physiological narrowing: at the exit of the pelvis, at the entrance to the pelvis and inside the gallbladder wall.
    The wall of the ureter consists of three layers: the outer connective tissue, medium - smooth muscle, and internal mucous membranes.
    In women, the urethra is in the immediate vicinity of the uterus and vagina.
    The passage of urine through the urethra at the expense of reductions segments of the ureter - Testoedov, usually three.

    The ureter (ureter). The ureter is a flattened tube 27-30 see From the renal pelvis, ureter goes down and medial to the nameless line of the pelvis, which divides the ureter into two anatomical and surgical Department: upper - abdominal and lower pelvic. The abdominal Department of the ureter is located on the inner edge m. psoatis and loosely span with the parietal peritoneum, remember, finding the ureter in this area. Identifying the importance of seed Vienna, which is held here lies lateral ureter and crosses his entrance in the pelvis. In the pelvic Department ureter arc which is convex in the lateral direction, heading down and medial to the bladder. The ureter flows into the lower wall of the bladder obliquely, probada her side of the center line, and opens on the mucosa of the bladder slotted at the top corner of the cystic triangle.
    At the level of lin. innominata pelvis ureter crosses iliac vessels, then is the more medially them. Coloposmy segment of the ureter crosses locking artery and vein and external umbilical artery, as well as the ductus deferens men and uterine artery in women.
    The wall of the urinary tract is formed by two layers of smooth muscles: the inner and outer longitudinal circular. In the wall of the bladder, ureter is surrounded by a third muscular layer, called the ureter vagina Waldeyer, which is functionally connected with the muscles of the bladder. The mucous membrane of the ureter is covered with laminated transitional epithelium.
    The gap in the ureter average of 5-8 mm At the exit from the pelvis, in the place of the intersection iliac vessels and in the thickness of the wall of the bladder, a gap in the ureter narrowed down to 3-4 mm
    Artery of the upper section of the ureter depart from renal arteries, medium - from seed and iliac, the bottom - from the gallbladder or uterine. Vienna correspond to the arteries.
    The lymphatic vessels of the upper section fall into renal cancer of wilusa, medium - retroperitoneal, lower - iliac lymph nodes.
    Innerviruetsya the ureter of the kidney, seed and iliac plexus.

    Of the anomalies of the ureter is most often found doubling of the ureter which can be complete - from kidney leave two of the ureter and bladder they open with one hand, two mouths or partial, when the ureter not doubled throughout and offers in the bladder one mouth. The doubling of the ureter is often accompanied by a doubling of the kidneys.
    Congenital atony of the ureter - the notion of a functional determined by the state of its dynamics. The ureter is extended, the wall of his are thinned. Atony accompanied by the delay in the passage of urine through the urethra. Atonic ureter called megaloptera.
    Often there is abnormal contraction of the gallbladder holes of the ureter and globular bulging out of his mouth - ureterocele, which is one - or two-way. Other abnormalities of the urinary tract are rare.
    Diagnosis of abnormalities of the ureter is done using cystoscopy (see), retrograde ureterograph (see) and excretory urography (see).
    Treatment of anomalies of the ureter - operative, when ureterocele - endovascular electrocoagulation the mouth of the ureter.
    Damage to the urethra closed arise from sudden compression of body, blunt or falling from a height and lead to full or partial rupture of the ureter.
    Signs of damage ureter is a pain in the lumbar region, blood in the urine, after a few days of high fever, and swelling in the lumbar region due to urinary streaks (see). With closed injury of the ureter produce drainage urinary streaks and nephrostomy; in the subsequent recovery operation on the ureter.
    Open injuries of the ureter more common in wartime. Signs - blood in the urine and the urine from the wounds. For suspected damage to the urethra produces excretory urography, the retrograde ureterograph. Operative treatment, as if the closed damage.
    Sometimes damage ureter occur during gynecological or obstetrical operations. If damage to the urethra during the operation installed, immediately restore the patency of the ureter. When unrecognized damage ureter is formed ureter fistula or narrowing of the urethra.

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