Ureter

Ureter – pair urinary body which serves for removal of urine in a bladder.

Ureter structure

The ureter begins from the narrowed site of a renal pelvis where the urine formed in a kidney flows down. Its output end comes to an end in a bladder wall. In this place mucous forms the fold interfering the return current of urine. The fold works as the valve as thanks to the muscle fibers which are contained in it it can actively be closed.

Externally the ureter has an appearance of a thin tube which has an outside cover from connecting fabric, an average muscular layer which fibers intertwine diversely, and an internal mucous membrane which forms longitudinal folds on all length of an ureter.

Part of an ureter is located in an abdominal cavity, and a part – in a cavity of a small pelvis. On all length its pieces of narrowing alternate with expansions. Diameter of this body in an abdominal cavity averages from 8 to 15 mm, in a small basin – to 6 mm. Considerable elasticity allows to extend to an ureter at difficulty of outflow of urine to 8 cm, for example, if in an ureter stones. The bottleneck – an exit from a renal pelvis, and it is biologically reasonable.

Functions of an ureter

The main function of an ureter is timely removal of the urine formed in kidneys in a bladder. At first the upper part of an ureter is filled, and thanks to reductions of muscle fibers in its wall urine moves ahead further, in a bladder, even in horizontal position of the person.

Inspection of ureters

Begin inspection with collecting complaints. Most often patients with diseases of ureters complain of a pain syndrome. Pains can be pricking, aching, pristupoobrazny, to give down a stomach. Defeat of pelvic department can give disturbance of a rhythm of an urination – a dysuria.

At a palpation of a stomach there can be tension of front its wall and morbidity on the ureter course. The lower piece of this body manages to be probed at a research through a vagina at women or a rectum at men.

In analyses of urine at pathology of ureters leukocytes and erythrocytes can be found. Most often this evidence of inflammatory changes or stones in ureters.

Tsistoskopiya allows to examine mouths of ureters in a bladder – their form, the sizes, an arrangement, availability in them of blood or purulent discharges. Hromotsistoskopiya allows to define the block of advance of urine because of a stone in an ureter or damages. Damage level can be determined at catheterization more precisely, besides it can become remedy for an ureter in need of removal of urine.

At survey urography ureters are not visible, but it is possible to notice in them X-ray contrast concrements. Their course is visible at a research with contrast – excretory urography. In these cases it is possible to find asymptomatic doubling of ureters also. In case of introduction of contrast from a bladder cavity the research is called a retrograde ureterografiya.

Sokratitelny opportunities investigate using X-ray cinematography, an elektroureterografiya. These types of inspections allow to reveal such dysfunctions of an ureter, hypo - or a hyperkinesia, hyper - or an atony.

Diseases of an ureter and approaches to their treatment

Distinguish the inborn and acquired pathology of ureters. Inborn diseases arise under the influence of disturbing factors on a fruit.

The hypoplasia often happens at an underdevelopment of the corresponding kidney. Diameter of an ureter decreases, in some places it can obliterate. Narrowing, or a stenosis, is most often formed in a vesicoureteral segment. In these cases perhaps operational treatment of an ureter with plastics of the struck segment.

Valves of an ureter are a doubling of an internal cover of body in the form of a fold, they meet quite seldom.

Inborn atony – one of the heaviest pathologies. Due to the lack of reductions the ureter very strongly extends. Clinically it can not be shown in any way, but in urine the resistant pyuria is found.

Acquired diseases generally are a consequence of disturbance of passability. It can be a consequence of a prelum from the outside or existence of an obstacle in a gleam.

From the outside of a prelum long locks, ureter excesses, gynecologic pathology, cancer diseases of a bladder, prostate, neck of uterus most often make.

At an urolithiasis small stones from a pelvis of a kidney can get to an ureter, breaking urine outflow. Surgery an ureterolithotomy is made for the purpose of removal from an ureter of stones if other methods were inefficient.

The cancer tumor, chronic inflammatory process (for example can cause obstruction of body except stones, at tuberculosis, a schistosomiasis). Treatment of ureters will consist in elimination of an obstacle or removal of an ureter in the operational way and drainage of a renal pelvis.

At fibrous defeat in area of retroperitoneal cellulose there is a fibrous polyureteritis. The ureter in this case is captured outside by fibrous fabric in the form of the coupling which squeezes it outside. This pathology can also be corrected only in the surgical way.