The ureter: a narrow path with great impact
The ureter is only a few millimeters wide and transports the urine from the kidney to the bladder. If this path stalls, the urine backs up, and the kidney suffers, often without it being noticed early. We ensure that drainage is restored, and treat as tissue-sparingly as possible.
Ureteral stones
Most stones form in the kidney and only cause complaints once they migrate into the narrow ureter. Then a colic can occur, a severe, wave-like pain that runs from the flank into the lower abdomen. If the stone blocks the drainage completely or fever is added, it becomes urgent, because the obstructed kidney can become infected.
Small stones we let pass under monitoring. If a stone is lodged or too large, we remove it endoscopically via a ureteroscopy, during which we see and fragment the stone. To relieve the obstructed kidney, we place a temporary internal stent (ureteral stent) if needed.
Ureteral narrowing (stricture)
A scarred narrowing of the ureter can arise after stones, inflammations, surgery, or radiotherapy; more rarely it is congenital. It impedes urine drainage and endangers the kidney. Short narrowings can be treated endoscopically; longer or recurrent ones require a reconstructive operation, in which we replace the narrowed segment or reconnect it to the bladder. These procedures we perform preferentially robot-assisted. More on this in the UPJ Obstruction and Ureteral Stricture section (already available) and under Reconstructive Urology (below).
Congenital drainage disorders
Some drainage problems exist from birth, such as a widened ureter (megaureter) or a backflow of urine from the bladder into the ureter (reflux). In adults they often only become apparent through recurrent infections or a declining kidney function. We clarify whether treatment is necessary, and correct where it protects the kidney.
Tumors of the ureter
In the ureter the same tumor type can arise as in the bladder, a urothelial carcinoma, here in the upper urinary tract. These tumors are rare but belong in specialized hands, because diagnosis and therapy are demanding and must also consider preservation of kidney function. The connections to urothelial carcinoma you will find in the Bladder section (below).
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Urokompetenz – The Center for Urology
Klinik für Urologie und Urochirurgie der Clinic Bel Etage
Reichsstraße 59
40217 Düsseldorf