People who often have a problem with the urinary system are very interested in many questions about this disease. There are many aspects, since the features of pathological processes are diverse, as are the variants of the form of the disease and the stage of development. It all depends on the structure of the organ of the ureters, and their direct functional norms.
Functions of the ureters and Bladder: many people are interested in how this organ and the bladder are arranged, their functional abilities, size and location. The bladder is called the organ where urine accumulates and is temporarily stored, which must regularly exit through the urination canal at regular intervals. The main role is that it is stored and allocated in urethra. According to the shape and position in the body, it is located depending on how much it is filled with urine and what gender the patient has.
The ureter in women: in the female, it is located in such a way that, with an empty bladder, it is located in the cavities where the small pelvis is. And the rectum is separated from it by the vagina and uterus. When it is full and there is urine in it, then its shape changes, if it is very full, it stretches and reaches the area where the navel is. How is it located in the male? With an empty bladder, it is located where the cavity is in the small pelvis, the rectum separates its seminal vesicles and areas where the vas deferens. At the same time, in the lower part, spliced with prostate, and in the upper section there is always mobility.
The upper surface is adjacent to the loop in the intestine. How is it located in a newborn baby? The ureter is located slightly differently in newborns. The ureters of a newborn have many differences, the ureter does not originate like in adults. First, the location of the bladder in newborns is much higher than in adults. From the first days of a child's life, every day it falls lower, and when the child is half a year old, it reaches the level of the upper edges of the fused pubic bones. Possesses hallmarks his internal structure and blood supply. The bladder has three layers, these are:
- muscular;
- slimy;
- serous.
In the muscle layer, there are three types of fibers that have the property of stretching and contracting. This usually occurs where the bladder transitions into the urination canal. At the same time, a kind of sphincter is formed in the muscle layer, in which the contraction function is developed, and involuntary. It is not dependent on a person, it is characterized by a mucous membrane, which has a pink color, it has folds.
Also on the shell there is the formation of small mucous glands and lymphatic follicles. The blood supply to this organ occurs with the help of the upper and lower cystic arteries. These arteries come from the basin of the large iliac artery. In the lymph, all the inguinal lymph nodes that are located nearby swell. There are 2 points - the lumen of the ureter and the diameter of the ureter. The position of the ureter depends on the stage of development of this process.
Functional actions
Like every organ, this one has the structure of the ureters. Parts of the ureter: intramural ureter, middle third of the ureter, valve of the ureter, orifice of the ureter, veins of the ureter. When the ureter develops, the width and length of the ureter depends on the structural features of the body. The ureter in men has some differences (there are 2 points). Sometimes there are abnormal processes (formation or formation of the development of the disease). These are diverticula, as they are called, when the wall protrudes and a bag-like appearance is formed. It comes in single and multiple versions.
In the diverticulum, stagnation of urine occurs, resulting in a disease such as cystitis. Another type is when the fistula is in the ducts, it is responsible for connecting the bladder through the umbilical cord to the amniotic fluid when it occurs intrauterine development. It is very rare if it is absent or underdeveloped. These spankings are incompatible with the vital activity of the organism. The organ originates from the pelvis, which is on the kidney. It is a kind of hollow tube, with a diameter of about six millimeters and a length of three hundred millimeters.
One of the tasks is the delivery of urine from the kidneys to the bladder, and, accordingly, preventing the reverse flow of urine. When the ureteral valve is affected, then the topography of the ureter is necessary (if necessary, it is done 2 times). There are three layers in the wall of organs - these are connective tissue, muscle and mucous. In the urinary system of the human body, certain organs are included that are responsible for ensuring that tasks and functions are performed, and each of these organs has its own function or task (it is especially important that everything functions correctly and there are no failures during pregnancy ).
Together they form a whole system of work. But if at least one organ is disturbed and it ceases to function, then the development of a disease of the entire urinary system occurs, and as a result, multiple unpleasant symptoms and discomfort(this is dangerous during pregnancy). The pathological process in the body is quite rare. By its nature, it can be congenital, inflammatory, tumor or traumatic (due to various injuries). Organ disease and symptoms this disease always manifest themselves in different ways, it all depends on what factors caused the disease (often, this is when the ureter valve is broken, it is dangerous during pregnancy).
Symptoms of dysfunction
If there was a lesion in the organ, then the clinical picture will manifest itself as pain coming from the lumbar region or the stomach will hurt on the side where the diseased organ is located. If irritation has formed in the lower part of the tube, then symptoms will appear frequent urination. Hematuria will form (2 times), if a violation has formed that affects the outflow of urine from the kidneys, then the symptoms will appear as spontaneous manifestations of renal colic. In this case, the excreted diuresis will decrease or urine will be completely absent.
It is also possible to observe nausea and vomiting, as well as increased arterial pressure. The most common disorders in the ureters are abnormal processes, they are formed due to a renal or intrinsic defect. These deviations are a quantitative indicator that causes non-compliance with the norms. This can be with congenital incorrect positions of structures and forms in the ureter, during pregnancy. Perhaps due to the fact that the stone was stuck in the organ, with the structure, this is when it narrowed, and the processes responsible for the outflow of urine were disrupted.
There are 2 cases when a patient after various diagnostics the doctor observes vesicoureteral refluxes. The type of this disease can be located and develop in the organ itself. It is characterized by the fact that underdevelopment occurred in the lower muscular valve or, due to some reason, the organ relaxed. In this case, urine can possibly come from the bladder. Due to serious pathological processes that interfere with work in the genitourinary system. Sometimes the development of a disease such as Ormond (purchased process) is formed. With its formation in the ureters, a process of complete obstruction or constant tissue compression can occur. This disease often occurs in men.
The consequences of the failure of the body
Formation of a megaureter when the system may not take urine. This is a type of disease when neuromuscular dysplasia occurs in the organ. Is congenital defect, and a characteristic structural change that gradually reaches the kidneys. Two types of progression are ureterocele, when a hernial defect is formed, in places where there is a connection to the bladder, in the intervals from the kidneys to the bladder, where tumor formation sometimes occurs. In patients with tuberculosis of the kidneys, care must be taken so that the disease does not spread to the ureter, since they are interconnected and the degree of progression of the disease is very high.
With epiema, a stump is a pathological process, when purulent accumulations form, they appear due to an already existing disease in one of the urinary structures. During pregnancy and the first symptoms of an unhealthy sign of the body, it is necessary to contact a specialist in a timely manner for help in a medical institution of this specialization. If there is an order of the genitourinary system or problems in the ureters, medical attention is also needed.
Symptoms of pain in the ureters in both women and men indicate that a disease has occurred in the urethra. It manifests itself in an independent way or due to the exacerbated action of pathological processes in any part of the genitourinary structures.
Restoration of the left kidney or the right one is carried out, since this is probably one of the reasons. The attending physician establishes this after a thorough diagnosis. The most important function of the ureters is to promptly remove urine from the kidneys to the bladder. As a rule, the upper section in the ureter is filled first, due to contractions of the muscle fiber in the walls, the urine begins to move and enters the bladder, even if the person is horizontal. Various examinations are carried out in the ureters when the patient talks about complaints (ultrasound of the right and left kidneys). As a rule, one of the complaints is a syndrome of constant pain.
In this case, the pain can be stabbing, aching and paroxysmal in nature, radiating to the stomach. When palpation is carried out, the anterior wall may be tense on the abdomen, and pain will occur along the ureters. After collecting the tests, if a pathological process has formed in the ureter, then the presence of leukocytes and erythrocytes will be detected in it. As a result, there will be an accurate diagnosis of the formation of inflammatory changes in the ureter. The anatomy of human organs is very interesting, and, as a rule, each organism has its own characteristics. Therefore, at the first sign of symptoms, it is necessary to consult a specialist.
Ureter(ureter) is a smooth muscle hollow somewhat flattened tube 26-31 cm long, connecting the renal pelvis with bladder. It consists of three parts: one is located in the retroperitoneal space, pars abdominalis, the second is in the subperitoneal tissue of the small pelvis, pars pelvina, and the third, the smallest, lies in the bladder wall, pars intramuralis.
The ureter has three constrictions. The upper one is located at its beginning, at the exit from the pelvis. Here its diameter is 2-4 mm. The average narrowing (up to 4-6 mm) is located at the intersection of the iliac vessels and the boundary line by the ureter. Lower (up to 2.5-4 mm) - directly above the place of perforation of the bladder wall by the ureter. In places of narrowing, most often there is a delay leaving the pelvis urinary stones. There are extensions between the constrictions: the upper one is up to 8-12 mm in diameter, the lower one is up to 6 mm.
Projections of the ureters.
to the front abdominal wall the ureter is projected in the umbilical and pubic regions, along the outer edge of the rectus abdominis muscle. The posterior projection of the ureter, that is, its projection onto the lumbar region, corresponds to a vertical line connecting the ends of the transverse processes of the lumbar vertebrae.
Ureter, like the kidney, is surrounded by sheets of retroperitoneal fascia, fascia extraperitonealis, and fiber, paraureterium, located between them. Throughout the ureter lies retroperitoneally.
Going down, in the direction from outside to inside, ureter crosses psoas major and n. genitofemoralis.
This proximity to the ureter to the nerve due to the irradiation of pain in groin, scrotum and penis in men and in the labia majora in women during the passage of a stone through the ureter.
Right ureter is located between the inferior vena cava from the inside and the caecum and colon ascendens from the outside, and the left one is between the abdominal aorta from the inside and the colon descendens from the outside.
Anterior to the right ureter located: pars descendens duodeni, parietal peritoneum of the right mesenteric sinus, a. and v. testicularis (ovarica), a and v. ileocolicae and radix mesenterii with lymph nodes located near them.
Anterior to the left ureter there are numerous branches a. and v. mesentericae inferiores, a. and v. testicularis (ovarica), the mesentery of the sigmoid colon, and above it - the parietal peritoneum of the left mesenteric sinus.
Ureters connected with the parietal peritoneum rather firmly, as a result of which, when the peritoneum is exfoliated, the ureter always remains on its posterior surface.
When moving into the pelvis right ureter usually intersects a and v. iliacae externae, left - a. and v. iliacae communes. The contours of the ureter in this segment are sometimes clearly visible through the peritoneum.
Ureter in upper third supply blood branches of the renal artery, in the middle - branches a. testicularis (ovarica). Deoxygenated blood flows along the veins of the same name with the arteries.
Drainage of lymph from the ureters sent to regional lymph nodes kidneys and further to the aortic and caval nodes.
Innervation of the abdominal ureter carried out from the plexus renalis, pelvic - from the plexus hypogastricus.
The ureters are paired tubes in the urinary system that serve as a connecting channel for the kidneys and bladder. Their length is 0.3 meters (on average), with a diameter of up to 7 mm. The ureter in women is somewhat shorter than in men, but the difference is usually only a couple of centimeters.
Structure
The wall of the ureter is made up of three layers:
- Outside - connective tissue;
- Inside - a mucous membrane covered with an elastic layer of the epithelium (with mucous glands), which allows the organ to be safely stretched and contracted;
- Between the outer and inner layers is muscle. Such muscles are necessary to move fluid to the bladder and push it into it, while it is so strong that it does not allow reverse actions (passage of urine from the bladder through the ureter).
Functions
The main task of the ureters is to remove the formed urine from the kidneys into the cavity of the bladder.
This action is provided by the same muscle layer, it carries out contractions, under the influence of which movement occurs. In one minute, 3-4 such emissions occur. And each time it is portions of a different size. Considering that there are two ureters in the human body at once, they divide the work into two and perform their function alternately. A strong “blocking” mechanism is able to restrain the flow of urine from the bladder under the most extreme conditions (with increased intravesical pressure and even with contractions of the organ at the time of urination).
Diseases
Pathologies in the ureters are recorded quite rarely. They can be congenital, inflammatory, obstructive, tumor or traumatic (if damaged) in nature.
Ureter disease symptoms manifest themselves in different ways, depending on what they were caused by.
If the ureter was affected, then clinical manifestation will be like this:
- Pain comes from the lumbar region or from the abdomen from the sick ureter;
- Perhaps their irradiation to the lower abdomen and genitals;
- If the lower part of the tube is irritated, then main feature- frequent urination;
- Hematuria.
In case of disorders affecting the outflow of urine from the kidney, the symptom picture is as follows:
- Spontaneous appearance of renal colic;
- Decrease in excreted diuresis or complete absence of urine;
- There may even be nausea with vomiting and an increase in blood pressure.
The most common disorders of the ureters include:
Treatment
As with any manifestation of unhealthy signs in the human body, he should immediately contact a specialized institution. Disorders in the genitourinary system, including the ureters, are no exception.
Pain in the ureter in women, as well as in men, may indicate various diseases urethra. They can appear both independently and as a result of exacerbation pathological process anywhere in the urinary tract.
Before resorting to therapy in the hospital, they must conduct a diagnosis and, based on its results, draw appropriate conclusions. Usually, ultrasound scans not only the ureters, but also the kidneys, due to the direct connection with which there are many transient diseases. The cause of the symptoms is clearly identified by the X-ray method with the use of contrast agents. In extremely advanced cases, computed tomography, and even ureteroscopy, may be needed.
If the disease is not serious enough drug treatment and diet, but there are situations when ureteroplasty is required. With such an operation, it is partially or completely replaced by the intestine.
stones 
Such foreign inclusions are frequent companions urinary system. They are formed in the kidneys, after which they "travel" through it. The ideal outcome can be considered the case when the stone is small in size and with a smooth structure. But this does not happen often, usually they do not pass asymptomatically. Often, inflammation of the ureter is observed, because it is not at all difficult to injure its delicate walls.
Stenting
As mentioned earlier, almost continuously our kidneys produce urine, which must constantly leave the body. But some diseases were also mentioned that contribute to the fact that this process is disrupted due to the narrowing of the wall of the urinary canal in diameter. For this, scientists have developed a new type of operation, in which a stand is placed in the ureter for a person. It removes the obstruction and restores the full outflow of urinary fluid.
The composition of the urinary system of patients of both sexes and all age groups includes two kidneys, two ureters, urethra and bladder.
The structure of the female ureter and the male one is somewhat different. This organ has the form of a hollow paired tube, up to 30 cm long.
The main purpose is to transport urine from the renal pelvis to the bladder. Urine moves thanks to the muscular layer, which is located on the walls of the tubes.
Topographic features
The ureter is the urethra that is used to ferry urine. The paired organ has a pelvic and peritoneal parts.
From the pelvis, the tube descends through the middle of the peritoneum to the small pelvis and connects to the bladder, perforating it obliquely.
Orifice of the ureter
This is an opening that penetrates the wall of the ureter and connects the bladder to the ureter. The mouth is located in the cavity of the urinary tract. At the connection point, a fold forms from the upper part of the duct. There is also a crease between the tubes. It acts as the base of the urea triangle - part of the mucous membrane.
The mouth is an anatomical narrowing of the duct, so stones usually get stuck in it. The accumulation of stones in this place causes the appearance pain, severe complications and dangerous consequences.
Abdominal
It starts in the retroperitoneum in the back of the abdomen. Further, it moves along the lateral region to the organs of the small pelvis, adjacent to the psoas muscle. The right organ begins its location behind duodenum. In the pelvic region, it moves beyond the sigmoid colon.
The left duct is located behind the bend between the jejunum and duodenum. In the pelvic region, it passes behind the base of the mesentery.
The pelvic part of the tube in women is placed behind the ovaries. It goes around the side of the uterine neck, runs along the uterine ligament, located between the vagina and the urea.
In men this department The tube passes in front of the seminal duct, and then flows into the urea under the top of the seminal vesicle.
The distal section, the furthest from the kidney, is located in the layers of the ureter wall. This part of the ureter is 1.5 cm long and is referred to as the intramural.
For convenience, physicians divide the urinary duct into three segments of identical length - upper, middle and lower.
Character traits
The ureters in both sexes begin in the renal pelvis. Then, through the peritoneum, they penetrate into the bladder in an oblique vector.
The walls of the paired organ consist of the following layers:
The diameter of the paired organ is not constant. This value may vary in different areas. AT healthy body tubes have several natural constrictions in certain places:
- transition of the pelvis into the ureter;
- exit of the ureter into the pelvic cavity;
- several areas in the pelvis, or throughout the size in the same area;
- before the junction of the ureter and bladder.
The length of the urethra is different for each sex. Their parameters depend on the article, age, individual anatomical properties of a person.
Female ureters
In women, paired tubes are 2-2.5 cm shorter than in men. In connection with anatomical features in the pelvic area, the ureters are bent due to the presence of the genital organs in that place.
The upper sections of the ducts run along the ovaries, then next to the broad uterine ligament. Then the tubes enter obliquely into the urea close to the vagina. At the transition point, a muscular sphincter is formed.
male pair duct
In men, in the pelvic cavity in front of the ureter, the ureter bends forward and deep, passes between the walls of the rectum and the bladder, and approaches the vas deferens at a right angle. Then it moves past the seminal vesicles and rests against the wall of the urea.
The size and diameter of the tubes in persons of different sexes also differ. In women, the ducts are shorter. Their length normally does not exceed 20-35 cm, the average diameter over the entire length is 5-6 mm. The male urinary organ is 2-2.5 cm longer, and the width is almost the same.
Since the tube has constrictions in certain places, slight pressure may appear along the entire length of the organ. If the ureter is healthy, the movement of urine is not impeded.
Blood supply to the ureter and main functions
The tissues of the urinary organs are nourished by the arterial blood supply. The vessels are located in the outer shell and stretch along the entire duct. The walls of the tubes are pierced small capillaries. The branches of the artery above move away from the female ovarian arteries and the arteries of the male ovaries. They also depart from the renal vessels. 
The middle section of the duct is fed with blood from the peritoneal aorta, the iliac artery of the internal and general functionality. The lower section is supplied with blood from the iliac arterial branches - cystic, rectal, uterine and umbilical. A bundle of vessels in the peritoneum passes in front of the ducts, and in the pelvic region - behind them.
The venous circulation is formed from the veins, which are located along the arteries. They serve to flow blood from the lower part to the iliac vein, from the upper region to the testicular or ovarian.
The flow of lymph occurs through channels to the lymph nodes of the lumbar and iliac regions.
Functional duties of the ureter
The main task assigned to the ducts is the transportation of urine from the pelvis to the bladder. A layer of muscles located in the wall of the duct contributes to a change in the diameter of the organ, which occurs due to pressure from the fluid flowing inside.
Under the influence of a change in the width of the tube, the urine is pushed through the ureter. The reverse flow of urine is not possible because the part of the ureter that is in the bladder functions as a safety valve and a valve.
Urinary ducts in children
Children's urinary system is much different from an adult. The difference lies in the size of the organs, their functional feature, structure and location. The ureters in children are characterized by greater tortuosity, hypotonicity and a large diameter.
These anatomical properties in some cases lead to impaired passage, poor outflow of urine. As a result of these phenomena, inflammatory processes microbial etiology in the organs of the upper section.
In children of the first four years of life, the length of the paired organ does not exceed 5-7 cm. The tube coils and has a number of knee-shaped segments. By the age of four, the length of the ureter increases to 15 cm.
In the area of the pelvis, the duct bends 90 degrees due to the development of the renal pelvis during the first twelve months of a child's life.
The inner muscle layer of the tube walls is rather poorly developed. Collagen fibers are too thin, so the elasticity of the entire organ is reduced.
The good work of the contractile mechanism and the constant rhythm of contractions contributes to a large transportation of urine through the urinary system.
Children are sometimes diagnosed congenital anomalies urethral growth:
- atresia - absence of ureters and urinary openings;
- megaloureter - an excessive increase in the diameter of the tube along the entire length;
ectopia - abnormal placement or attachment of the ureters, including with the intestines. Pathological entry into the urethra past the bladder, communication with the genital organs of the internal and external location.
Methods for diagnosing the anatomy of an organ
As diagnostic measures, methods are used that can thoroughly determine the clinical picture of the pathology. In the presence of stones in the male ureter, the following research methods are used:
- determining and evaluating the patient's medical history, symptoms and complaints;
- palpating examination of the abdomen;
- Ultrasound examination of the organs of the peritoneal cavity and small pelvis;
- instrumental diagnostics.
For diseases of the ureters, pronounced pain is characteristic with the following signs:
- constant paroxysmal or aching nature;
- irradiation of pain in the lumbar region, groin, external genitalia, lower abdomen; in children, pain often radiates to the umbilical region.
The place of development of the pathological process is determined according to the distribution scheme:
- the disease develops in the upper third of the duct - the pain syndrome is reflected in the hypochondrium;
- pathological signs of the middle section are given by pain in the groin;
- diseases of the lower third are reflected unpleasant sensations in the external reproductive organs.
By palpation, the doctor evaluates the tension of the anterior abdominal muscles along the ureter. For a thorough examination, two-handed palpation is performed, which gives more accurate results. Two fingers of one hand are inserted into the anus or vagina of a female patient, with the other hand making counter movements.
As laboratory research do an analysis of urine for the presence of an excessive number of red blood cells and. Excess normal indicators indicates damage to the lower ureter.
Among other things, to study the pathologies of the ureters, cystoscopy, chromocystoscopy, ureteral catheterization, an overview urogram, excretory urography, urotomography, and urokimography are performed.
Interesting functional features
The functions of the urinary ducts are under the total control of the autonomic nervous system. The upper part of the tubes is in contact with the processes vagus nerve. The opposite part, together with the pelvic organs, communicates with innervation.
In the body, paired tubes serve as transporters of urine from the kidneys to the bladder. Their main function is to push the excreted urine from to the bladder.
The work of the ureter is provided by cellular contractions of the muscle layer. The frequency of contractions depends on the functionality of the cells of the urinary system. The constancy of the rhythm is affected by:
- the rate of formation and purification of urine;
- posture in which the body is located;
- physiological state of the urinary system;
- features of the work of the neurovegetative system.
The functionality of the ureter depends on the quantitative content of calcium compounds in the body. Calcium balance in the muscles affects the force of organ contraction. Thanks to this mineral, uniform pressure is provided in the kidneys and pelvis, which has a positive effect on the operation of hollow tubes.
Normally, a healthy ureter pumps 10-14 ml of urine per minute. The internal pressure in the duct adjusts to, in the urea - to the pressure in the ureter. This cycle is called reflux, and if it is disturbed, painful symptoms and physiologically unpleasant phenomena will appear.
Anatoly Shishigin
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The human genitourinary system contains a pair of ureters, two kidneys, a urethral canal, and a bladder. Anatomically, the structure of women and men differs, but at the same time it always represents a hollow tube up to 30 centimeters long. The main function of this organ is the delivery of urine from the pelvis in the kidneys to the bladder, which occurs with the help of contractions of the muscle layer in the walls of the bladder.
The ureter has a special structure, like any organ in the human body, it contains several sections, pelvic and proximal, as well as distal. Of these, it is the proximal ureter, which is located at the very top, that is very important for diagnosis. genitourinary system. In it, pathologies are most often found.
The localization of the organ begins in the pelvic part in the kidneys. It is located at the entrance, where there is a constriction. The end of the tube enters the bladder, where there is a hole in the form of a slit - the mouth. At the confluence, a fold is formed, which is covered with mucous membranes on both sides.
In the shell of the mouth there are muscle fibers, due to which the contraction and closure of the lumen in the ureter occurs, which is a natural barrier to the reverse flow of urine. The walls of the tube consist of a complex plexus of muscle bundles in different directions, which are covered by a transitional epithelium and a mucous membrane with elastic fibers. Longitudinal folds are formed along the entire length. The outer layer is covered by the adventitia and fascia.
Localization Features
The ureter is located in the tissue of the peritoneum near its back, passing with its part to side surfaces small pelvis. In the ureter there is a pelvic and abdominal part, in length it can be from 28 cm to 34, which depends on the location of the kidney in the body.
The cross section is different - expansion and contraction alternate. In the lumen, the narrowest part is located near the very beginning, only 2-4 mm, and also in the transition to the pelvic cavity - 4-6 mm, and the widest section is 8-15 mm. In the pelvis, the ureteral tube is very elastic and reaches 6 mm in its lumen. When expanding, an increase of up to 8 mm occurs.
The nuances of the blood supply
The branches of the ureter in the form of arteries depart from the renal in the uppermost section, as well as from the ovarian and testicular, and in the lower part - from iliac arteries, uterine, umbilical and bladder. Through the nerve plexuses of the vegetative type in the pelvis or peritoneum, innervation is carried out.
In the ureter, a rhythmic function of the motor autonomous type is noted, and the pacemaker, the pacemaker, is the generator. It is located at the top in the pelvic mouth. The rhythms of contractions depend both on the type of body position and on the rate of urine filtration, as well as on mental state patient, with irritation in the urinary tract.
Pressure
The ability of muscles to contract depends on the content and quantity of calcium ions. The pressure in the ureter is higher than in the pelvis and bladder organ. This ensures the highest urine perfusion of 10 ml/min.
The pressure in the pelvis in the urinary tube depends on similar indicators in the bladder, since a single innervation in the terminal part, the mouth and the urine reservoir determines the correct functioning of these organs during the transport of urine and prevents the occurrence of reflux.
How is the ureter examined?
The ureter is examined in several ways, among which are general clinical, instrumental and radiological. As a rule, in diseases of this organ, the patient complains of pain in attacks, aching or stabbing, radiating to the groin with pathologies in the middle section, to the genitals - in the lower, and to the iliac region - with diseases in the upper part. If the pelvis and the inside of the urine tube are affected, the patient experiences dysuria.
Palpation
Palpation refers to general clinical methods, and the doctor determines the tension of the walls in the peritoneum and pain along the ureter. Its lower section is examined with two hands, through the rectum or vagina. Urinalysis in the laboratory reveals hematuria and the presence of a large number leukocytes.
Cystoscopy continues the study by palpation, reveals the shape and structure of the organ, the discharge of blood or pus in it. If a contrast agent is used, it is possible to determine the failure of the outflow of fluid in the presence of blockage by a stone or clot.
Urography
When performing catheterization of the ureters, the presence of obstacles in it is determined, and urine is also taken for analysis, retrograde ureteropyelography is done. When examining x-rays, the procedure begins with an overview type urography. In the picture during this study, the tube itself is not visible, but shadows of the formations and calculi present can be seen along the entire length. The course of fluid through this organ can be noted on infusion-type urograms.
Retrograde ureterography
If necessary, retrograde ureterography is performed. If it is necessary to identify pathologies in the ratio of the spatial location of the studied organ relative to neighboring ones. You can do urotomography, which is distinguished by its layering. The combination with retrograde type ureteropielography and excretory urography will be especially effective.
The contractility of the organ in some cases reveals atony, hypotension or hyperkinesia, which becomes noticeable during urokimography. The most thorough examination will be only with X-ray television and X-ray cinematography. The most common method is ureteroscopy.
Pathologies
The ureter often has malformations, among which stenosis, aplasia, doublings, ureterocele, muscle dysplasia, vesicorenal reflux, ectopia can be noted. different kind at the mouth. Sometimes the defects are not expressed by clinical manifestations.
Doubling
Doubling of the ureter does not cause disturbances in the functioning of the body, most often it is detected randomly during examinations for other patient complaints. But malformations in the development of the body causes a malfunction of the upper urinary tract. constrictions in anatomical structure and difficulty in the movement of urine in any of the departments of the organ disrupts its peristalsis, urine stasis, deforms and expands the structure and functions of the kidney. In this case, pyelonephritis develops.
Decreased muscle tone
Muscle tone decreases and leads to changes in the ureter and kidneys. Failure of the function of the renal system also occurs with a complex pathology of the development of the parenchyma in the kidneys and in the ureter.
Malformations
With defects in the organ, among the symptoms most often there is inflammation in the urinary tract, heat, pain syndromes in the abdomen and lower back, dysuria, protein and leukocytes in the analyses. Factors that provoke the development of pyelonephritis also cause respiratory diseases - tonsillitis, etc. With an ectopic orifice of the vaginal type, as well as when located in the ureter or uterine canal, urine leakage occurs between acts, both regular and periodic.
If you diagnose defects on early stage, then the results of treatment will be much more effective. Therefore, even if one-time leukocytes of about 100 units appeared in urine tests against the background of temperature, then a urological examination should be carried out. Ultrasound will be effective, which determines dilatation in the pelvis and calyces, the renal parenchyma, and can also show dilation that affects the proximal ureter.
Radionuclide methods and X-rays give an adequate assessment of the kidney and urological organs, reveal obstruction and determine medical tactics. The treatment of such pathological defects takes place promptly, and before the operation it is necessary to drink a course of medications and do physiotherapy, the action of which is aimed at leveling the inflammation and its relief.
Ureter injury
Damage can be partial or complete, closed or open. The reasons can be both surgical and endovesical interventions. Symptoms in this case are blood in the urine, leakage of urine, leakage of urine from the formed wound, obstruction of the upper parts of the organ. The diagnosis is made after ureteropyelography, urography, chromocystoscopy, ultrasound.
Treatment is most often surgical, except for cases of catheter perforation, dressing after gynecological interventions. Then the patency is restored by installing drainage or stenting.
If the perforation of the organ wall is detected late and infiltration and inflammation have begun, then drainage is done. The operation can be done only 4 weeks after the injury. As a preventive measure, experts advise catheterization.
What diseases are most common?
In any disease, the clinical picture is marked by a violation of the movement of urine through the organ, with pain in the lower back, renal colic, inflammation in the upper urinary tract. Most often, ureteritis appears, which occurs after the development of diseases of the kidneys and bladder, with reflux and inflammation in the membranes of the organ. Also, the cause of ureteritis can be prostatitis or retroperitoneal fibrosis, an abscess of the appendicular type.
If movement of urine is detected, then it is necessary to pass antibiotic therapy, make drainage of the renal system.
Cystic ureteritis
Cystic ureteritis is very rare in chronic stage ordinary ureteritis, while cysts appear on the mucous membranes, inside of which there is a transparent content.
Cystic or villous ureteritis is considered a disease that precedes cancerous lesions of the body. Conservative therapy in this case is ineffective, therefore, nephroureterectomy is performed, especially in cases of unilateral lesions.
Tuberculosis
Tuberculosis of the ureter is most often secondary, when tuberculosis of the kidney spreads. AT clinical symptoms note a failure with the movement of urine along the upper urinary tract. The diagnosis is made according to the results of excretory urography, when strictures and lesions in the kidneys are detected in it, according to cystoscopy, the specialist notes swelling in the area of the mouth and its mucous membranes, often this phenomenon takes the form of a funnel and tubercles.
With poor tone of the muscle layer and trophism of the walls, vesicoureteral reflux occurs. Initial stages tuberculosis of this organ are amenable to conservative treatment anti-tuberculosis drugs, if scars are formed, then bougienage of the organ is necessary. With a stricture detected on ureterohydronephrosis, resection, ureterocystoanastomosis, and nephroureterectomy are prescribed.
stones
Formations in this organ are always secondary and they are located above the stricture or narrowing. If the calculus is in the same place for a long time, then there is a stricture and bedsores. Clinical picture the same as in urolithiasis.
Stones that are found on x-rays are still visible on plain x-rays, and those that are not visible on contrast analyzes in a retrograde or excretory type urogram. The presence of stones in the ureter can be confirmed by ultrasound of the dilatation of the kidneys, and extensions in the upper third of the organ are also detected there.
Diagnosis of the lower part is carried out in different projections on the X-ray, when a contrast agent is injected through the catheter, and if there is a suspicion of a tumor, then a ureterogram is needed. If the stone stays still for a long time, then the kidneys fail, a nephrostomy is done for release, and then a radiological examination and renal arteriography, which determines the final choice of treatment therapy.
Conservative treatment consists of water load, antispasmodics, calculus removal therapy, vibrotherapy, ultrasound stimulation. If there is no effect, then lithotripsy is performed, which causes complications with subsequent surgical intervention. If the stones are large and scars appear, then only surgery will help.
Strictures
Strictures appear as a result of pathology (ureteritis, urolithiasis disease or tuberculosis), but are also congenital. With congenital etiology, the location affects the pyeloureteral region. The stricture can be true when the pathology grows in the thickness of the organ, or it can be false, from the outside, in the form of a scar or tumor nearby.
With strictures of the ureter, retention occurs in the department that is located above, as well as the kidneys, which experience hydronephrosis and ureterohydronephrosis. These diseases determine an effective therapeutic treatment regimen, to which a complex of X-ray radionuclide techniques is added.
Leukoplakia
This disease is very rare and develops against the background of inflammation with a long stay of stones in the same place. Clinically, the picture appears to be obstruction of the urinary tract in upper divisions with the development of ureterohydronephrosis. In urine tests, studies reveal epithelial plates in a keratinized state, as well as scales.
