Ureteral spasm

Introduction The ureter is a tubular organ with a slender, muscular mucosa located in the retroperitoneal space, surrounded by good protection and a considerable range of motion. Muscles suddenly do not arbitrarily contracture, commonly known as cramps, will make patients feel severe pain, muscle movements are not coordinated. The patient straightens the muscles of the affected area and usually reduces the degree of paralysis.

Cause

It is induced by cold and strenuous exercise. Kidney stones, trauma, stress. Frequently causing smooth muscle spasm and cramping, such as colic, often sudden pain, such as knife cuts, lower abdominal genital area and inner thigh radiation, sometimes patients with pale complexion, cold sweat, nausea, vomiting, severe pulse, rapid blood pressure, etc. Symptomatic cavity surgery and the application of ureteral injuries caused by ureteral instruments, in some cases, the diagnosis was not confirmed due to the insignificant symptoms. With the development of endoscopic urology, the number of ureteral injuries caused by instrument operation has increased.

an examination

Related inspection

Ureteroscopy ureteroscopy

The pain is often located in the lower back and abdomen, and most of them are paroxysmal and can also be persistent pain. Some pain may only manifest as soreness and discomfort in the waist. Activities or labor may cause pain to increase or worsen. Kidney stone colic is severely knife-like pain, often sudden onset, pain often radiates to the lower abdomen, groin or medial femoral, and women radiate to the labia. When the kidney colic is onset, the patient is acutely ill, distorted in the bed, pressed against the abdomen or waist with both hands, and even rolled over the bed, stunned. The episode often lasts for hours and can be relieved in a matter of minutes. When the renal colic is severe, the face is pale, the body is cold and sweaty, the pulse is fine and fast, and even the blood pressure drops, showing a state of collapse, accompanied by nausea, vomiting, and abdominal distension. When the colic is attacked, the amount of urine is reduced, and after the colic is relieved, there may be polyuria.

Differential diagnosis

Need to be identified with the following symptoms:

Ureteral cyst: ureteral cyst: a cystic dilatation of the end of the ureter. During the embryonic development, the septum between the ureter and the urogenital sinus does not absorb and resolve, forming different degrees of stenosis of the ureteral orifice, or the fibrous structure at the end of the ureter is weak or the path between the wall is too long, and the curve is caused by the urinary flow. After the formation of a cystic dilation into the bladder. Early cases are clinically asymptomatic and are often found in the diagnosis of severe renal deformities. Symptoms are mainly urinary tract obstruction, causing repeated urinary tract infections. Due to the small opening of the cyst, persistent obstruction of the ureteral orifice can lead to ureter and hydronephrosis, loss of renal function, cystic occlusion of the bladder neck, dysuria or interruption of urinary flow, and recurrent urinary tract infection. Sometimes girls cysts can be removed from the urethra through the bladder neck and urethra, and can usually be reset by themselves. However, an incarcerated purple mass can also occur. The principle of treatment is to relieve obstruction, prevent reflux, and deal with complications. If the upper half of the affected side is dysfunctional, it can be used for partial nephrectomy. About 20 to 25% of cases still have symptoms after surgery, and the cysts are treated again. If the kidney function is good, it can be used for ureteral cyst resection and anti-reflux ureteral bladder replantation.

Ureteral obstruction: obstruction of the ureteropelvic junction is a common urinary tract obstruction that causes hydronephrosis. Because the obstruction of the ureteropelvic junction obstructs the smooth discharge of renal pelvis into the ureter, the renal pelvis emptying disorder causes the renal system to expand. At first, the smooth muscle of the renal pelvis gradually proliferates, strengthens the peristalsis, and attempts to discharge the urine through the distal obstruction; when the increasing amount of creeping power cannot overcome the obstruction, it will lead to atrophy of the renal parenchyma and impaired renal function. Ureteral pain: ureteral pain is often an acute attack, often secondary to acute ureteral obstruction.

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