Ureteral pain

Introduction Often acute, more secondary to acute ureteral obstruction.

Cause

Mostly due to stones or blood clots and other factors caused by acute expansion of the ureter, peristalsis, ureteral smooth muscle spasm.

an examination

Related inspection

Intravenous urography, rouge test, renal pelvis, chlamydia, urinary catheterization

The part of the pain is often the part of the obstruction. The pain caused by the right ureteral obstruction can be confused with appendicitis in the lower right abdomen; the left ureteral pain is easily confused with diverticulitis in the lower left abdomen.

Differential diagnosis

The diagnosis should be differentiated from the following symptoms:

1. Ureteral stenosis: There are 3 physiological curvatures of the ureter, which is the stenosis. The first stenosis is penetrated into the bladder wall; the second stenosis is inserted across the radial artery into the small pelvis; the third stenosis is penetrated into the bladder wall.

Ureteral stenosis refers to the ureteral lumen or the whole segment is narrower than normal due to various reasons. Although the continuity of the lumen is not interrupted, it has caused different degrees of upper urinary tract obstruction and hydronephrosis.

2. 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.

3. Ureteral fistula: The ureter is a slender, muscular organ composed of tubular organs located in the retroperitoneal space, with good surrounding protection and 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.

4. Ureteral cyst: is 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.

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