Primary atony urinary tract

Primary atony of the ureter is expressed in the expansion of its clearance in the absence of mechanical obstacles to the flow of urine. It should not be confused with secondary atony of the ureter infectious or retention of origin. The primary reason atony is congenital hypoplasia of the nervous and muscular component of the wall of the urethra. The mouth of the ureter gaping. The stagnation of urine in the advanced atonic the ureter leads to the development of hydronephrosis.
Congenital atony of the ureter can be one - or two-way. Often atony ureter is accompanied by a congenital atony bladder. Urination during this difficult, the bladder is emptied, the amount of residual urine varies widely.
Clinical phenomena in atony one of the ureter are expressed in a dull pain in the lumbar region, which in the presence of a urinary infection join the symptoms of pyelonephritis. When bilateral atony develop phenomena renal failure. Patients often die at an early age from uraemia and urosepsis.
In atony one of the ureter, without atony bladder, the prognosis is much better. Sometimes anomaly does not manifest until you join the infection.
The key value for the diagnosis has accent panoretrograph, giving a picture of the extended ureter on one or both sides (Fig. 65).
Expressed moderate and asymptomatic atony one of the ureter not require treatment. Frequent pain in far comes hydronephrosis, especially the infected shown removal of the kidney with the ureter at all its length (total nephroureterectomy).
In atony both ureters treatment is to fight infection with antibiotics and antimicrobials. In acute infections, cannot be controlled with medications, you can resort to the imposition of renal fistula (nephrostomy) and drainage kidneys. Recently in atony ureter is applied replacing it with a loop of small bowel on the mesentery - putting plastic.