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In this category the ureters' valvular mechanism is initially intact and healthy but becomes overwhelmed by increased bladder pressures associated with obstruction, which distorts the ureterovesicular junction. The obstructions may be anatomical or functional. Secondary VUR can be further divided into anatomical and functional groups.
These include partial or total duplication of the ureter (a duplex ureter), or the formation of a second irregularly placed ureter; [13] or where the junction with the bladder is malformed or a ureterocoele develops (usually in that location). [14]
Ureterovesicular junction obstruction (UVJ obstruction) is an obstruction at the level of the ureter and bladder. It accounts for 20% of cases of hydronephrosis detected in utero. It is also most commonly seen in males and involved both sides of the urinary tract in approximately 25% of cases. [1]
The ureters run posteriorly on the lateral walls of the pelvis. They then curve anteriormedially to enter the bladder through the back, at the vesicoureteric junction, running within the wall of the bladder for a few centimeters. The backflow of urine is prevented by valves known as ureterovesical valves.
Hydronephrosis describes hydrostatic dilation of the renal pelvis and calyces as a result of obstruction to urine flow downstream. Alternatively, hydroureter describes the dilation of the ureter, and hydronephroureter describes the dilation of the entire upper urinary tract (both the renal pelvicalyceal system and the ureter).
The trigone (also known as the vesical trigone) [1] is a smooth triangular region of the internal urinary bladder formed by the two ureteric orifices and the internal urethral orifice.
The site of stenosis was the ureterovesical junction in most of the patients with eosinophilic ureteritis. [13] Fibrosis of the bladder wall and reduced bladder compliance can compress the intramural portion of the ureter in eosinophilic cystitis. [14]
The vesicouterine pouch is a fold of peritoneum over the uterus and the bladder, forming a pelvic recess. [1] It is continued over the intestinal surface and body of the uterus onto its vesical surface, which it covers as far as the junction of the body and cervix uteri, and then to the bladder.