The ureter stones

the stone in the ureter
Fig. 5. The stone in the ureter

The ureter stones almost always secondary, as they are formed in the kidney, and then get into the ureter. The stones can be single or multiple. Stone size is usually not greater than the diameter of the ureter, round or oval, with a smooth or prickly surface. Sometimes on the stone there is a fillet - urinary track". Linger ureter stones in physiological contractions, often in the pelvic or intramural Department of the ureter. Fixed stones cause inflammatory changes in the wall of the urethra - ureteric.
Signs stones ureter are renal colic (see Renal disease), blood in the urine( frequent urination, vomiting, sometimes abdominal pain, tension of the abdominal muscles.
Diagnostics ureter stones using chromolithography, overview snapshot, excretory urography and retrograde ureteroplasty.
For differential diagnosis of "acute abdomen" is of great importance chromatotherapy (see Cystoscopy).
When ureter stones used conservative treatment - testinal 5-10 drops on sugar 3-5 times a day, olimetin 1 capsule (0.5 g) 3-5 times a day, reception of spasmolytics, and drugs; the heat in the form of hot water bottle or baths, treatment in the resorts of Truskavets, Essentuki, etc. With fixed stones, disrupt the function of the kidneys, showing surgery.


Fig. 4. Various kinds of stones ureter

Inflammatory diseases of the ureter - ureteric - can be primary or secondary. Primary meet seldom occur abruptly - with increasing temperature, paroxysmal pain in the lumbar region with irradiation in the course of the ureter, due to the violation of the outflow of urine from the kidney due to swelling of the ureter. Treatment in most cases, conservative.
Secondary ureteric arise as a consequence of the inflammatory process in the kidneys, when ureter stones, with vesicoureteral - reflux (see). Long-flowing ureteric strikes and connective tissuesurrounding the urethra. Due uretrita develops scar narrowing of the urethra, which contributes to a more severe course of the basic disease.
Diagnosis and treatment of secondary uretrita associated with the diagnosis and treatment of the underlying process. When Cicatrical stenosis of the ureter showing surgery.
Tuberculosis of the ureter - process is always secondary (tuberculosis of the kidneys). On the mucous membrane of the ureter appear TB bumps, which are then izyaslau, being cheesy disintegration. The process captures the entire thickness of the walls of the ureter, the lumen of the ureter narrowed, ureter is shortened. When the scarring ulcers of the ureter arise narrowing of the urethra up to a full stop outflow of urine from the kidney (see Hydronephrosis).
Currently TB treatment ureter mainly conservative. When a pronounced narrowing of the urethra - operative, until the removal of the ureter, together with the kidney.
Leukoplakia and malakoplakia ureter diseases, occurring rarely considered precancerous. When leukoplakia appear sections orogovevshie epithelium on the mucous membrane of the ureter, if malakoplakia - brown plaques, protruding above the surface of the mucous membrane. Treatment - operative.
Tumors of the ureter are primary and secondary. Primary tumors of the ureter, especially connective tissue (sarcoma), are rare.
Tumors of epithelial structures (papillary cancers and others) are more often in the lower part of the ureter. The main feature of the tumor ureter is blood in the urine, sometimes in the form of a worm-like clots. In violation of the growing outflow of urine from the kidneys into the lumen of the ureter tumor occurs the enlargement of kidneys and pain in the lumbar region.
Tumors of the ureter diagnosed by cystoscopy, catheterization of the ureter and ureterograph.
Treatment of tumors of the ureter - operative.
Operations in the ureter produce mainly for the purpose of removal of stones ureter - ureterolithotomy - or to restore normal clearance of the ureter in the narrowing of it, as well as tumors of the ureter, leukoplakia and malakoplakia. When the narrowing of the pelvic-ureteric segment and hydronephrosis produce ureterolithiasis - the release of the ureter of modified fibrous tissue and plastic surgery. When narrowing preduzimaju Department of the ureter or mochetocnikov-vaginal fistula produce transplant ureter at the top of the bladder - ureterosigmoidostomy, or operation of Bari consisting in education from the flap of the bladder wall pipes, replacing the lower third of the ureter. In addition, proposed a number of plastic surgeries, warning vesicoureteral reflux.