Ureteral Injuries

Ureteral injuries are the rarest of all genitourinary injuries and are usually the result of penetrating trauma ( Fig.254-1). Blunt trauma, however, can induce a rupture at or just below the ureteropelvic junction as a result of hyperextension of the spine with the distal ureter fixed at the trigone of the bladder. Blast effects from gunshot wounds may cause microvascular thrombosis in the ureteral wall, delayed ureteral necrosis, and urinary fistula formation. Diagnosis is sometimes delayed. If the ureter is completely transected, hematuria may be absent.11 IVP is likely to miss such injuries.11 Enhanced CT or a retrograde pyelogram may be required for detection.

FIG. 254-1. Rare ureteral injury from a gunshot wound, with extravasation of contrast material on retrograde pyelogram.

Cure Your Yeast Infection For Good

Cure Your Yeast Infection For Good

The term vaginitis is one that is applied to any inflammation or infection of the vagina, and there are many different conditions that are categorized together under this ‘broad’ heading, including bacterial vaginosis, trichomoniasis and non-infectious vaginitis.

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