Injuries to the ureter can occur after penetrating abdominal injuries, and injuries at high speeds followed by an abrupt stop (such as a high speed car accident). The ureter can be injured during surgery to nearby structures. It is injured in 2 per 10,000 cases of vaginal hysterectomies and 13 per 10,000 cases of abdominal hysterectomies, usually near the suspensory ligament of the ovary or near the cardinal ligament, where the ureter runs close to the blood vessels of the uterus.
Injury
Ureter
Ureter | Injury
Yes, Injuries to the ureter can occur after penetrating abdominal injuries, and injuries at high speeds followed by an abrupt stop Yes. The ureters can be affected by a number of diseases; including urinary tract infections and kidney stone. Yes. penetrating abdominal injuries,High speed car accident, surgery to nearby structures Yes, injuries can occur after penetrating abdominal injuries
what tissue types form the wall of the ureter
user
urothelial cells
assistant
what is ureter?
user
The ureters are tubes made of smooth muscle that propel urine from the kidneys to the urinary bladder.
assistant
what is the size of this tube?
user
The ureters are between 1.5 - 6 mm in diameter, and surrounded by a layer of smooth muscle for 1 - 2 cm near their ends just before they enter the bladder.
assistant
can you name one function of this bladder?
user
Urine, excreted by the kidneys, collects in the bladder
assistant
do mammals also have this bladder?
user
Yes, all mammals have a urinary bladder
assistant
is it also prone to any deadly disease?
user
Yes, bladder cancer
assistant
does the tube also have anything to do with the supply of blood?
user
Yes, the arteries which supply the ureter vary along its course
assistant
do stones also form here?
user
Yes, a kidney stone can move from the kidney and become lodged inside the ureter
assistant
and what causes this stone to form in this tube?
user
Sorry. I cannot find the answer based on the context.
assistant
can these tubes also get damaged?
user
Injuries to the ureter can occur after penetrating abdominal injuries, and injuries at high speeds followed by an abrupt stop (such as a high speed car accident). The ureter can be injured during surgery to nearby structures. It is injured in 2 per 10,000 cases of vaginal hysterectomies and 13 per 10,000 cases of abdominal hysterectomies, usually near the suspensory ligament of the ovary or near the cardinal ligament, where the ureter runs close to the blood vessels of the uterus.
Ureter | Injury
Passage of kidney stones through the urethra can be painful. Damage to the urethra, such as by kidney stones, chronic infection, cancer, or from catheterisation, can lead to narrowing, called a urethral stricture. The location and structure of the narrowing can be investigated with a medical imaging scan in which dye is injected through the urinary meatus into the urethra, called a retrograde urethrogram. Additional forms of imaging, such as ultrasound, computed tomography and magnetic resonance imaging may also be used to provide further details. Injuries to the urethra (e.g., from a pelvic fracture) Foreign bodies in the urethra are uncommon, but there have been medical case reports of self-inflicted injuries, a result of insertion of foreign bodies into the urethra such as an electrical wire.
Urethra | Injury
If drainage is compromised for longer periods, the kidney can be damaged. Stents may also be placed in a ureter that has been irritated or scratched during a ureteroscopy procedure that involves the removal of a stone, sometimes referred to as a 'basket grab procedure'. Stents placed for this reason are normally left in place for about a week. These stents ensure that the ureter does not spasm and collapse after the trauma of the procedure.
Ureteric stent | Stent placement
When nerves to the back are damaged, the bladder cannot empty, resulting in stagnant urine.
Bladder stone | Signs and symptoms
Blockage, or obstruction of the ureter can occur, as a result of narrowing within the ureter, or compression or fibrosis of structures around the ureter. Narrowing can result of ureteric stones, masses associated with cancer, and other lesions such as endometriosis tuberculosis and schistosomiasis. Things outside the ureters such as constipation and retroperitoneal fibrosis can also compress them. Some congenital abnormalities can also result in narrowing or the ureters. Congenital disorders of the ureter and urinary tract affect 10% of infants. These include partial or total duplication of the ureter (a duplex ureter), or the formation of a second irregularly placed () ureter; or where the junction with the bladder is malformed or a ureterocoele develops (usually in that location).
Ureter | Anatomical and surgical abnormalities
Many other complications arise from ureteroceles. Redundant collection systems are usually smaller in diameter than single, and predispose the patient to impassable kidney stones. The effective "bladder within a bladder" compounds this problem by increasing the collision of uric acid particles, the process by which uric acid stones are formed. Ureterocele is also associated with poor kidney function. It can cause frequent blockage of the ureter leading to serious kidney damage. In other cases, a small, upper portion of the kidney is congenitally non-functional. Though often benign, this problem can necessitate the removal of non-functioning parts.
Ureterocele | Complications
The purpose of this study is to identify and characterize injuries to the urethra. The tip of a small (12F) foley catheter is placed in the urethral meatus. The catheter remains fixed after 3 mL of water are instilled into the foley catheter's balloon. Radiographic films are taken as 20 mL of water-soluble contrast material are injected This outlines the urethra from the urethral meatus to the bladder neck. If injuries exist, the location can be determined.
Genitourinary tract injury | Retrograde Urethrography (RUG)
A kidney stone can move from the kidney and become lodged inside the ureter, which can block the flow of urine, as well as cause a sharp cramp in the back, side, or lower abdomen. Pain often comes in waves lasting up to two hours, then subsides, called renal colic. The affected kidney could then develop hydronephrosis, should a part of the kidney become swollen due to blocked flow of urine. It is classically described that there are three sites in the ureter where a kidney stone will commonly become stuck: where the ureter meets the renal pelvis; where the iliac blood vessels cross the ureters; and where the ureters enter the urinary bladder, however a retrospective case study, which is a primary source, of where stones lodged based on medical imaging did not show many stones at the place where the iliac blood vessels cross.
Ureter | Ureteral stones
The ureters are tubes made of smooth muscle that propel urine from the kidneys to the urinary bladder. In the human adult, the ureters are usually long and around in diameter. The ureter is lined by urothelial cells, a type of transitional epithelium, and has an additional smooth muscle layer in third closest to the bladder that assists with peristalsis. The ureters can be affected by a number of diseases; including urinary tract infections and kidney stone. is when a ureter is narrowed, due to for example chronic inflammation. Congenital abnormalities that affect the ureters can include the development of two ureters on the same side, or abnormally placed ureters.
Ureter | Introduction
If a patient has a stone lodged higher in the urinary tract, the physician may use a much finer calibre scope called a ureteroscope through the bladder and up into the ureter. (The ureter is the tube that carries urine from the kidney to the bladder.) The physician can then see the stone and remove it with a small basket at the end of a wire that is inserted through an extra tube in the ureteroscope. For larger stones, the physician may also use the extra tube in the ureteroscope to extend a flexible fiber that carries a laser beam to break the stone into smaller pieces that can then pass out of the body in the urine.
Cystoscopy | Male and female urinary tracts
Rupture of the urethra is an uncommon result of penile injury, incorrect catheter insertion, straddle injury, or pelvic girdle fracture. The urethra, the muscular tube that allows for urination, may be damaged by trauma. When urethral rupture occurs, urine may extravasate (escape) into the surrounding tissues. The membranous urethra is most likely to be injured in pelvic fractures, allowing urine and blood to enter the deep perineal space and subperitoneal spaces via the genital hiatus. The spongy urethra is most likely to be injured with a catheter or in a straddle injury, allowing urine and blood to escape into the scrotum, the penis, and the superficial peritoneal space.
Urethral rupture | Introduction
Ureteroureterostomies are often performed because of injured or scarred ureters, especially when the ureter in question is damaged in its upper third section. Generally if the patient has distal uretral strictures (narrowing of the ureter), a ureteroureterostomy is not recommended and a ureter reimplantation would be favorable.
Ureteroureterostomy | Reasons for performing procedure
Ureteroscopy has become increasingly popular as flexible and rigid fiberoptic ureteroscopes have become smaller. One ureteroscopic technique involves the placement of a ureteral stent (a small tube extending from the bladder, up the ureter and into the kidney) to provide immediate relief of an obstructed kidney. Stent placement can be useful for saving a kidney at risk for postrenal acute kidney failure due to the increased hydrostatic pressure, swelling and infection (pyelonephritis and pyonephrosis) caused by an obstructing stone. Ureteral stents vary in length from and most have a shape commonly referred to as a "double-J" or "double pigtail", because of the curl at both ends.
Kidney stone disease | Ureteroscopic surgery
Most stones are compounds containing calcium such as calcium oxalate and calcium phosphate. The first recommended investigation is a CT scan of the abdomen because it can detect almost all stones. Management includes analgesia, often with nonsteroidal antiinflammatories. Small stones (< 4mm) may pass themselves; larger stones may require lithotripsy, and those with complications such as hydronephrosis or infection may require surgery to remove.
Ureter | Ureteral stones
Ureteral development begins in the human fetus around the 4th week of embryonic development. A ureteric bud, arising from the mesonephric (or Wolffian) duct, gives rise to the ureter, as well as other parts of the collective system. In the case of a duplicated ureter, the ureteric bud either splits or arises twice. In most cases, the kidney is divided into two parts, an upper and lower lobe, with some overlap due to intermingling of collecting tubules. However, in some cases the division is so complete as to give rise to two separate parts, each with its own renal pelvis and ureter.
Duplicated ureter | Pathophysiology
More invasive forms of imaging include ureteroscopy, which is the insertion of a flexible endoscope into the urinary tract to view the ureters. Ureteroscopy is most commonly used for medium to large-sized stones when less invasive methods of removal are not able to be used.
Ureter | Imaging
Sensation supplied is sparse close to the kidneys and increases closer to the bladder. Sensation to the ureters is provided by nerves that come from T11 - L2 segments of the spinal cord. When pain is caused, for example by spasm of the ureters or by a stone, the pain may be referred to the dermatomes of T11 - L2, namely the back and sides of the abdomen, the scrotum (males) or labia majora (females) and upper part of the front of the thigh.
Ureter | Nerve supply
The ureter is lined by urothelium, a type of transitional epithelium that is capable of responding to stretches in the ureters. The transitional epithelium may appear as a layer of column-shaped cells when relaxed, and of flatter cells when distended. Below the epithelium sits the lamina propria. The lamina propria is made up of loose connective tissue with many elastic fibers interspersed with blood vessels, veins and lymphatics. The ureter is surrounded by two muscular layers, an inner longitudinal layer of muscle, and an outer circular or spiral layer of muscle. The lower third of the ureter has a third muscular layer.
Ureter | Microanatomy
This indicates that the stones were intentionally removed and didn't fall off the structures over time due to natural processes.
Actuncan site | E-Group and Structure 19A
Urogenital tuberculosis may cause strictures of the ureter, which, however, may heal when infection is treated.
Urogenital tuberculosis | Complications
The stones would have had to be collected and carried to the site, probably from the river as many are rounded and river worn. No detailed description of the urns survives other than some details of the size and their present location is not recorded. By 1857 Mr. James Neilson Provan of Peacockbank was the landowner. The urns contained bones and relics and these vessels were found enclosed in small excavations that were close to the original ground level. One urn, around a foot in diameter, was broken whilst being removed. The remaining two urns had a diameter of 5½ inches and were six inches in height.
Cairnduff | History
Hyperechoic stones are seen with accompanying posterior shadowing. Additional twinkling artifacts below the stone can often be seen using Doppler US. Large stones filling the entire collecting system are called coral stones or staghorn calculi and are easily visualized with US (Figure 20). Stones in the ureters are usually not visualized with US due to the air-filled intestines obscuring the insonation window. However, ureteral stones near the ostium can be visualized with a scan position over the bladder. An exam of the ureteric orifices and the excretion of urine to the bladder can be performed by inspecting the ureteric jets in the bladder with color Doppler US.
Renal ultrasonography | Kidney stone disease
The gastrocnemius tubercle is just distal and posterior to the adductor tubercle.
Medial knee injuries | Bones
Urinary stones may be composed of the following substances:
Bladder stone | Classification
With creation of a urinary diversion it is possible for the ureters to become obstructed preventing the drainage of urine from the kidneys. If this occurs, another procedure to insert a percuntaneous nephrostomy tube may be need to allow drainage of urine from the body. Obstruction of the ureter most commonly occurs at the site where the ureters are reconnected to the urinary diversion created. A small, hollow, flexible tube called a stent may be placed inside the ureter at the time of surgery to possibly help the reconnection site to heal. This reconnection site is also at risk for leaking urine within the abdomen.
Cystectomy | Urinary tract
It can be fractured along with the tibial tuberosity.
Gerdy's tubercle | Introduction
Bladder stones may occur whenever the kidneys, bladder, or ureters become inflamed, which may occur when the urine becomes too concentrated or when the body becomes dehydrated. Minerals such as calcium and magnesium crystallize into the stones, which then can cause such symptoms as lower back or abdominal pain or difficulty with urination. The use of urinary catheters may cause a bladder stone. Individuals who are paralyzed or are unable to adequately pass urine may require the use of small plastic tubes (catheters) placed into the bladder. The use of these tubes may lead to an infection, which irritates the bladder, resulting in stone formation.
Bladder stone | Causes
Following this, in the 19th and 20th centuries multiple terms relating to the structures such as ureteritis and ureterography, were coined. Kidney stones have been identified and recorded about as long as written historical records exist. The urinary tract including the ureters, as well as their function to drain urine from the kidneys, has been described by Galen in the second century AD. The first to examine the ureter through an internal approach, called ureteroscopy, rather than surgery was Hampton Young in 1929. This was improved on by VF Marshall who is the first published use of a flexible endoscope based on fiber optics, which occurred in 1964.
Ureter | History
If a partial cystectomy is performed, damage to the ureter may occur depending of the location of the tumor removed. This may require an additional procedure to repair.
Cystectomy | Urinary tract
If the ureters have been resited as a result of surgery, for example due to a kidney transplant or due to past surgery for vesicuureteric reflux, that site may also become narrowed. A narrowed ureter may lead to ureteric enlargement () and cause swelling of the kidneys (hydronephrosis). Associated symptoms may include recurrent infections, pain or blood in the urine; and when tested, kidney function might be seen to decrease. These are considered situations when surgery is needed. Medical imaging, including urinary tract ultrasound, CT or nuclear medicine imaging is conducted to investigate many causes. This may involve reinserting the ureters into a new place on the bladder (reimplantion), or widening of the ureter.
Ureter | Anatomical and surgical abnormalities
A ureteric stent may be inserted to relieve an obstruction. If the cause cannot be removed, a nephrostomy may be required, which is the insertion of a tube connected to the renal pelvis which directly drains urine into a stoma bag.
Ureter | Anatomical and surgical abnormalities
In this case, usually one ureter drains correctly to the bladder, with the duplicated ureter presenting as ectopic.
Ectopic ureter | Introduction
Management depends on what part of the urethra was injured and to what extent. The two broad anatomical separations are the posterior and anterior urethra. The posterior urethra includes the prostatic and membranous urethra. The anterior urethra includes the bulbous and pendulous portion.
Genitourinary tract injury | Urethral Injuries
Finally, a kidney stone may travel down the ureter into the bladder and become a bladder stone. There is some evidence indicating that chronic irritation of the bladder by retained stones may increase the chance of bladder cancer. Urinary schistosomiasis, a disease caused by the digenean trematode "Schistosoma haematobium", has been implicated in the development of vesical calculi. However, evidence accumulated thus far has not supported this hypothesis.
Bladder stone | Causes
Ureteritis is a medical condition of the ureter that involves inflammation. One form is known as "ureteritis cystica". Eosinophilic ureteritis has been observed. Ureteritis is often considered part of a urinary tract infection.
Ureteritis | Introduction
Lithiasis (stone formation) in the bladder is called cystolithiasis (), from "cysto-" (bladder/cyst) + "-lith" (stone) + "-iasis" (disorder).
Bladder stone | Etymology
Breaks, losses, or abrasions can be caused by improper handling, impact (dropping), or excavation. Ceramics are strong in compression, but weak under tension, meaning they are fragile and susceptible to mechanical shock.
Conservation and restoration of ancient Greek pottery | Physical damage
Throughout the books of the Hippocratic Corpus, there are varying hypotheses as to reasons why and exactly how urinary tract stones actually formed. It is noted that these hypotheses were all based on the use of uroscopy and observation of patients by doctors of the time.
Hippocratic Corpus | Stone Formation Theories
When they do not dissolve correctly and further build up, they will commonly lodge themselves in the urinary tract and in this case, are usually small enough to pass through urine. In extreme situations, however, these stones may lodge themselves within the tube that connects the kidney and the bladder, called the ureter. In this case, they become very large in size and will most likely cause great pain, bleeding, and possibly even block the flow of urine. These can occur in both men and women, and studies show that around 12% of men, and 8% of women in America will develop kidney stones within their lifetime.
Excretory system | Kidney Stones
The position these holes precisely repeats the structure of the whole stone ring, each hole corresponds to a menhir of the ring.
Megaliths in the Urals | Menhirs
The plugs are then struck with hammer in sequence. An audible tone from the wedges changes to a 'ringing sound' when the wedges are tight. Between each series of strikes, a pause of several minutes allows the stone to react to the pressure. Eventually a crack appears along the line that was scored on the surface and the stone splits apart. Attempting to split the stone too quickly may cause the stone to "blow out" at the site of the plug or split at an undesirable section. While the stone might be recoverable, it requires additional work.
Plug and feather | Technique
The complication rate associated with ureterostomy procedures is less than 5–10%. Risks during surgery include heart problems, pulmonary (lung) complications, development of blood clots (thrombosis), blocking of arteries (embolism), and injury to adjacent structures, such as bowel or vascular entities. Inadequate ureteral length may also be encountered, leading to ureteral kinking and subsequent obstruction. If plastic tubes need inserting, their malposition can lead to obstruction and eventual breakdown of the opening (anastomosis). Anastomotic leak is the most frequently encountered complication. Normal results for a ureterostomy include the successful diversion of the urine pathway away from the bladder, and a tension-free, watertight opening to the abdomen that prevents urinary leakage.
Ureterostomy | Risks
They are designed to allow urine to flow past an obstruction in the ureter. They may be retained in the ureter for days to weeks as infections resolve and as stones are dissolved or fragmented by ESWL or by some other treatment. The stents dilate the ureters, which can facilitate instrumentation, and they also provide a clear landmark to aid in the visualization of the ureters and any associated stones on radiographic examinations. The presence of indwelling ureteral stents may cause minimal to moderate discomfort, frequency or urgency incontinence, and infection, which in general resolves on removal. Most ureteral stents can be removed cystoscopically during an office visit under topical anesthesia after resolution of urolithiasis.
Kidney stone disease | Ureteroscopic surgery
In 1820 it was recorded that other urns might be present ""as not more than a fourth part of it has yet been examined"". A height of 5 to 6 feet measured in 1820 with stones possibly removed previously for road building, etc.
Cairnduff | Description
This typically entails a direct excision of the now strictured area and anastomosis of the bulbous urethra to the prostate's apex. A urethral catheter and suprapubic cystostomy should be left in place. These are removed within a month.
Genitourinary tract injury | Posterior Urethra Injuries
Ureteral stents are used to ensure the openness of a ureter, which may be compromised, for example, by a kidney stone or a procedure. This method is sometimes used as a temporary measure, to prevent damage to a blocked kidney, until a procedure to remove the stone can be performed. Indwelling times of 12 months or longer are indicated to hold ureters open, which are compressed by tumors in the neighbourhood of the ureter or by tumors of the ureter itself. In many cases these tumors are inoperable and the stents are used to ensure drainage of urine through the ureter.
Ureteric stent | Stent placement
Cancer of the ureters is known as ureteral cancer. It is usually due to cancer of the urothelium, the cells that line the surface of the ureters. Urothelial cancer is more common after the age of 40, and more common in men than women; other risk factors include smoking and exposure to dyes such as aromatic amines and aldehydes. When cancer is present, the most common symptom in an affected person is blood in the urine; it may not cause symptoms, and a physical medical examination may be otherwise normal, except in late disease. Ureteral cancer is most often due to cancer of the cells lining the ureter, called transitional cell carcinoma, although it can more rarely occur as a squamous cell carcinoma if the type of cells lining the urethra have changed due to chronic inflammation, such as due to stones or schistosomiasis.
Ureter | Cancer
The following factors may be involved in causing this deformity:
Genu recurvatum | Causes
Occasionally, if a male's penis is damaged or removed, or a female's genitals/urinary tract is damaged, other urination techniques must be used. Most often in such cases, doctors will reposition the urethra to a location where urination can still be accomplished, usually in a position that would promote urination only while seated/squatting, though a permanent urinary catheter may be used in rare cases.
Urination | Urination after injury
Penetrating injuries can be caused by accidents during sexual activities (typically, by foreign objects inserted into the urethra), by weapons (i.e. bullets) during wartime, or by stabbing. These injuries can have varying severity and be superficial, affect the corpora cavernosa, other soft tissue, and/or urethra. In 50% of cases, the urethra is injured. Some foreign objects may be removed like any other penetrating object in soft tissue; using forceps and gentle traction. However, if the foreign object was inserted into the urethra or has damaged the urethra transversely, urethography is used to avoid further injury to the urinary tract while removing the object.
Penile injury | Penetration
A bladder stone is a stone found in the urinary bladder.
Bladder stone | Introduction
Postrenal azotemia and hydronephrosis can be observed following the obstruction of urine flow through one or both ureters. Pain in the lower-left quadrant can sometimes be confused with diverticulitis because the sigmoid colon overlaps the ureter, and the exact location of the pain may be difficult to isolate due to the proximity of these two structures.
Kidney stone disease | Signs and symptoms
The Indeterminacy Stones, begun in 1994, consisted of a chunk of pyrite, set atop a piece of marble, and then left outdoors to weather. The pyrite transformed into limonite when exposed to the elements, leaving a permanent iron rust stain. It may take less than ten years or over a century to dissolve depending on composition and environment. For the first exhibition of these works at Sandra Gering Gallery, New York, 1995, three boulders were gathered—one flat, one vertical, one wedge-shaped. Ann Barclay Morgan, writing about work in Sculpture Magazine, commented “…the action of “bleeding”…could be seen as the female life-force in the process of being released.
Dove Bradshaw | "Indeterminacy" (1995)
The membranous urethra can be separated from the prostate's apex after blunt trauma. The urethra should not be catheterized. Initial management should be the creation of a suprapubic cystostomy for urine drainage. The bladder should be opened in the midline so to facilitate inspection of bladder lacerations. Perforations can be closed with absorbable sutures. The suprapubic cystostomy remains in place for three months. Incomplete urethral disruptions heal spontaneously and the suprapubic cystostomy can be removed after three weeks for these injuries. Before removing a cystostomy, a voiding cystourethrography should demonstrate no urine extravasation. Delayed urethral reconstruction may be performed within 3 months.
Genitourinary tract injury | Posterior Urethra Injuries
Renal colic is a type of abdominal pain commonly caused by obstruction of ureter from dislodged kidney stones. The most frequent site of obstruction is the vesico-ureteric junction (VUJ), the narrowest point of the upper urinary tract. Acute obstruction and the resultant urinary stasis (disruption of urine flow) can distend the ureter (hydroureter) and cause a reflexive peristaltic smooth muscle spasm, which leads to a very intense visceral pain transmitted via the ureteric plexus.
Renal colic | Introduction
This was reputedly caused by an engineer from the Manchester Ship Canal, who used the stone to demonstrate a detonator. Excavations of the site were done by Professor Fleur of Manchester University in 1936 and 1937, with the aim of restoring the site as much as possible to its former condition.
The Bridestones | Subsequent destruction
A significant quantity of rounded stones are still present and some are exposed to view in situ or spread around the site. A few larger boulders, possibly perimeter stones are present and the indications are that the diameter of the cairn may originally have been over 20m. The stones are whinstone and mostly large. No hammer or chisel marks were found on any of the stones. The three urns found were buried in pits that were close to the original ground level. One urn was around a foot in diameter and the other two were 5½ inches in diameter and six inches in height, with zig-zag lines around the rim.
Cairnduff | Description
If the cause is obstruction of the urinary tract, relief of the obstruction (with a nephrostomy or urinary catheter) may be necessary.
Acute kidney injury | Postrenal
The ureters are muscular ducts that propel urine from the kidneys to the urinary bladder. In the human adult, the ureters are usually 25–30 cm (10–12 in) long. In humans, the ureters arise from the renal pelvis on the medial aspect of each kidney before descending towards the bladder on the front of the psoas major muscle. The ureters cross the pelvic brim near the bifurcation of the iliac arteries (which they run over). This "pelviureteric junction" is a common site for the impaction of kidney stones (the other being the uteterovesical valve). The ureters run posteriorly on the lateral walls of the pelvis.
Excretory system | Ureter
IVU-shows Adder head appearance or Cobra head appearance. Cystoscopy-shows translucent cyst which is thin walled surrounding ureteric orifice
Ureterocele | Diagnosis
The kidney is the most commonly injured urinary tract organ. Injuries occur commonly after automobile- or sports-related accidents. A blunt force is involved in 80-85% of injuries to the kidney. Major decelerations can result in major vascular injuries near the kidney's hilum. Gunshots and knife wounds commonly are the cause of penetrating injuries. Fractured ribs can result in penetrating injuries to the kidney. Injuries to the urethra occur most commonly in men after pelvic fractures or straddle-type falls.
Genitourinary tract injury | Introduction
The ureters develop from the ureteric buds, which are outpouchings from the mesonephric duct. This is a duct, derived from mesoderm, found in the early embryo. Over time, the buds elongate, moving into surrounding mesodermal tissue, dilate, and divide into left and right ureters. Eventually, successive divisions from these buds form not only the ureters, but also the pelvis, major and minor calyces, and collecting ducts of the kidneys. The mesonephric duct is connected with the cloaca, which over the course of development splits into a urogenital sinus and the anorectal canal. The urinary bladder forms from the urogenital sinus.
Ureter | Development
A pelvic fracture can cause the urethra to separate, leading to a variable length of scar that can severely hamper the ability to urinate normally. The urethra is a tubular conduit that transports urine out of the bladder. The bulbar urethra is a segment of the male urethra that is in between the penile urethra and the membrano-prostatic urethra that typically has a robust blood supply. This blood supply includes antegrade flow from the paired bulbar arteries and circumflex arteries, and retrograde flow from the paired dorsal arteries of the penis.
Bulbar urethral necrosis | Description
Prenatally diagnosed hydronephrosis (fluid-filled kidneys) suggest post-natal follow-up examination. The strongest neo-natal presentation is urinary tract infection. A hydronephrotic kidney may present as a palpable abdominal mass in the newborn, and may suggest an ectopic ureter or ureterocele. In older children, ureteral duplication may present as:
Duplicated ureter | Diagnosis
The ureters are richly supplied by nerves that form a network () of nerves, the ureteric plexus that lies in the adventitia of the ureters. This plexus is formed from a number of nerve roots directly (T9-12, L1, and S2-4), as well as branches from other nerve plexuses and nerves; specifically, the upper third of the ureter receives nerve branches from the renal plexus and aortic plexus, the middle part receives branches from the upper hypogastric plexus and nerve, and the lower ureter receives branches from the lower hypogastric plexus and nerve. The plexus is in the adventitia. The these nerves travel in individual bundles and along small blood vessels to form the ureteric plexus.
Ureter | Nerve supply
Additionally, reflux of urine from the bladder back up the ureters is a condition commonly seen in children. The ureters have been identified for at least two thousand years; with the word ureter stemming from the stem relating to urinating and seen in written records since at least the time of Hippocrates. It is however only since the 1500s that the term "ureter" has been consistently used to refer to the modern structure; and only since the development of medical imaging in the 1900s that techniques such as X-ray, CT and ultrasound have been able to view the ureters. The ureters are also seen from the inside using a flexible camera, called ureteroscopy, which was first described in 1964.
Ureter | Introduction
3–20% of people who form kidney stones have medullary sponge kidney.
Kidney stone disease | Risk factors
This distressing desire to fully void despite its impossibility is attributed to the irritation of urothelium (epithelium lining the urinary tract), especially of the trigone, and subsequent spasm of muscles. It is seen in numerous urological conditions including kidney stones, (especially when a stone is impacted at the vesicourethral junction), bladder stones, bladder inflammation (cystitis), and bladder cancer.
Strangury | Introduction
In older adults, the most common cause of hydronephrosis is benign prostate hyperplasia (BPH), or intrapelvic neoplasms such as prostate cancer. Compression of one or both ureters can also be caused by other developmental defects not completely occurring during the fetal stage such as an abnormally placed vein, artery, or tumor. Bilateral compression of the ureters can occur during pregnancy due to enlargement of the uterus. Changes in hormone levels during this time may also affect the muscle contractions of the bladder, further complicating this condition.
Hydronephrosis | Causes
Kidney stones have been identified and recorded about as long as written historical records exist. The urinary tract including the ureters, as well as their function to drain urine from the kidneys, has been described by Galen in the second century AD. The first to examine the ureter through an internal approach, called ureteroscopy, rather than surgery was Hampton Young in 1929. This was improved on by VF Marshall who is the first published use of a flexible endoscope based on fiber optics, which occurred in 1964. The insertion of a drainage tube into the renal pelvis, bypassing the uterers and urinary tract, called nephrostomy], was first described in 1941.
Kidney | History
http://www.public.asu.edu/~mesmith9/1-CompleteSet/MES-78-ShaftTombs.pdf
Shaft and chamber tomb | Sources
Twenty curved plates, or ossicles, are fused together to form a rigid test or exoskeleton. They are made of calcium carbonate, and have two rows of holes for the tube feet to pass through. If the test is cracked or chunks are removed, calcium carbonate will slowly fill in the gaps left behind until a complete and rigid test is regained.
Strongylocentrotus droebachiensis | Test
Because the tube may injure or perforate the esophagus, gastric lavage is contraindicated.
Lewisite | Treatment
A urethral stricture is a narrowing of the urethra caused by injury, instrumentation, infection, and certain non-infectious forms of urethritis.
Urethral stricture | Introduction
The broken tubes will require assessment from a professional conservator/neon specialist.
Conservation and restoration of neon objects | Handling damaged neon
This is for causes other than gall stones. At admission: Within 48 hours: For acute pancreatitis secondary to gall stones.
Ranson criteria | Usage
Ureteroscopy is an examination of the upper urinary tract, usually performed with a ureteroscope that is passed through the urethra and the bladder, and then directly into the ureter. The procedure is useful in the diagnosis and treatment of disorders such as kidney stones and urothelial carcinoma of the upper urinary tract. Smaller stones in the bladder or lower ureter can be removed in one piece, while bigger ones are usually broken before removal during ureteroscopy. The examination may be performed with either a flexible, semi-rigid or rigid device while the patient is under anesthesia. In specific cases, the patient is free to go home after the examination.
Ureteroscopy | Introduction
As noted above (section on calcium oxalate stones), people with inflammatory bowel disease (Crohn's disease, ulcerative colitis) tend to have hyperoxaluria and form oxalate stones. They also have a tendency to form urate stones. Urate stones are especially common after colon resection. Uric acid stones appear as pleomorphic crystals, usually diamond-shaped. They may also look like squares or rods which are polarizable.
Kidney stone disease | Uric acid stones
Walls of the tube are typically agglutinated with small quartz grains.
Archaeichnium | Description
The ureters enter the bladder from its back surface, traveling before opening into the bladder at an angle on its outer back surface at the slit-like "ureteric orifices". This location is also called the vesicoureteric junction. In the contracted bladder they are about apart and about the same distance from the internal urethral orifice; in the distended bladder these measurements may be increased to about . A number of structures pass by, above, and around the ureters on their path down from the kidneys to the bladder. In its upper part, the ureter travels on the psoas major muscle, and sits just behind the peritoneum.
Ureter | Structure
The museum provides 300 years of the history of urology, beginning from early and extremely dangerous kidney stone surgeries to modern ultra sound treatments that "pulverizes these jagged mineral clumps without any need to enter the body". It includes illustrations, urological tools such as catheters, cytoscopes (includes Nitze cystoscopes made in 1890 with platinum loops for illumination and rotating cystoscopes), operating resectoscopes, laparoscopes, lithotriptors, and resectoscopes; some of this urologic equipment was sterilized using formaldehyde or cyanide. All was donated by urologists, including Ernest F. Hock of Binghamton, New York, Hans Reuter of Stuttgart, Germany and Adolf A. Kutzmann of Los Angeles.
William P. Didusch Center for Urologic History | Collection
Urethral strictures most commonly result from injury, urethral instrumentation, infection, non-infectious inflammatory conditions of the urethra, and after prior hypospadias surgery. Less common causes include congenital urethral strictures and those resulting from malignancy. Urethral strictures after blunt trauma can generally be divided into two sub-types; Other specific causes of urethral stricture include:
Urethral stricture | Causes
Insufficient submucosal length of the ureter relative to its diameter causes inadequacy of the valvular mechanism. This is precipitated by a congenital defect or lack of longitudinal muscle of the portion of the ureter within the bladder resulting in an ureterovesicular junction (UVJ) abnormality.
Vesicoureteral reflux | Primary VUR
Kidneys and ureters located in incorrect position, including horseshoe kidney and ectopic ureters.
Bladder outlet obstruction | Anomalies of position
This may result in deformations and stenoses.
Perichondritis | Introduction
One adult, and one young child, displayed signs of violent injury with a tool.
Niedertiefenbach (megalithic tomb) | Anthropology
Alternatively, the site may be of volcanic origin.
Gatun structure | Introduction
Overall, the substructure is badly damaged: the collapse of a layer of the limestone beams has covered the burial chamber. No trace of the mummy, sarcophagus, or any burial equipment has been found inside. The severity of the damage to the substructure prevents further excavation.
Pyramid of Neferirkare | Substructure
Several forms of medical imaging exist that are used to view the ureters and urinary tract. Ultrasound may be able to show evidence of blockage because of hydronephrosis of the kidneys and renal pelvis. CT scans, including ones where contrast media is injected intravenously to better show the ureters, and with contrast to better show lesions, and to differentiate benign from malignant lesions. Dye may also be injected directly into the ureters or renal tract; an antegrade pyelogram is when contrast is injected directly into the renal pelvis, and a retrograde pyelogram is where dye is injected into the urinary tract via a catheter, and flows backwards into the ureters.
Ureter | Imaging
The coordinates for the stones are:
University Boat Race Stones | Introduction
These striations often stand in high relief above the rock surface itself.
Nectocaris | Anatomy
The best method for diagnosing this is to do an early ultrasound.
Ectopic pregnancy | Tube damage
Kidney stones have been identified and recorded about as long as written historical records exist. The urinary tract including the ureters, as well as their function to drain urine from the kidneys, has been described by Galen in the second century AD. The first to examine the ureter through an internal approach, called ureteroscopy, rather than surgery was Hampton Young in 1929. This was improved on by VF Marshall who is the first published use of a flexible endoscope based on fiber optics, which occurred in 1964. The insertion of a drainage tube into the renal pelvis, bypassing the uterers and urinary tract, called nephrostomy], was first described in 1941.
Urinary system | History
Stone size influences the rate of spontaneous stone passage. For example, up to 98% of small stones (less than in diameter) may pass spontaneously through urination within four weeks of the onset of symptoms, but for larger stones ( in diameter), the rate of spontaneous passage decreases to less than 53%. Initial stone location also influences the likelihood of spontaneous stone passage. Rates increase from 48% for stones located in the proximal ureter to 79% for stones located at the vesicoureteric junction, regardless of stone size. Assuming no high-grade obstruction or associated infection is found in the urinary tract, and symptoms are relatively mild, various nonsurgical measures can be used to encourage the passage of a stone.
Kidney stone disease | Treatment
Over time, as the bladder enlarges, it absorbs the surrounding parts of the primitive ureters. Finally, the entry points of the ureters into the bladder move upwards, owing to the upward migration of the kidneys in the developing embryo.
Ureter | Development
Increasing fluid intake can facilitate the passage of small bladder stones. However, larger stones may require other methods of treatment. Fragmentation of bladder stones can be achieved by use of a cystoscope which is inserted into the bladder. The urologist visualizes the stone and uses ultrasonic energy or laser lithotripsy to cause fragmentation of the stones into small pieces, which are then flushed out of the bladder. This procedure requires anesthesia and may require admission to a hospital. Complications of this treatment include infection and damage to the bladder. Some stones are too large even for cystoscopic treatment and may require open cystotomy, in which an incision is made in the bladder and the stones are removed manually.
Bladder stone | Management
Renal colic typically begins in the flank and often radiates to below the ribs or the groin. It typically comes in waves due to ureteric peristalsis, but may be constant. It is often described as one of the most severe pains. Although this condition can be very painful, most ureteric stones under 5 mm size will eventually pass into the bladder without needing treatments, and cause no permanent physical damage. The experience is said to be traumatizing due to the severe pain, and the experience of passing blood and clots as well as pieces of stone. In most cases, people with renal colic are advised to drink more water to facilitate passing; in other instances, lithotripsy or endoscopic surgery may be needed.
Renal colic | Signs and symptoms
Stones can cause disease by several mechanisms: A number of important medical conditions are caused by stones:
Calculus (medicine) | Pathophysiology and symptoms
From one stone a slab runs south and could be part of a tomb chamber or cist set in an oval cairn 1m high.
Eightercua | Introduction
When a blood vessel, usually the renal artery, crosses over the superior infundibulum of the kidney (one or both), fluid begins to build up, causing the calyx to become distended. This stretching allows the backed up fluid to be more evenly distributed, which can slow the amount of damage done on the kidney. Within this area, the ability to remove waste and maintain mineral and fluid balance become impaired. This leads to an increased risk of infection and stone formation, often causing flank pain. Furthermore, infections can cause further inflammation of the lining of the urinary tract; enough to cause blood to appear in the urine.
Fraley syndrome | Pathophysiology