Ureter disorders

Ureter disorders

Updated: 11/03/23
© Jun Wang, MD, PhD

Ureteral obstructions
  • Intrinsic
Stones, usually lodge at (a) ureteropelvic junction, (b) where ureters cross iliac artery and (c) where ureters enter bladder
Strictures (congenital or due to sclerosing retroperitoneal fibrosis)
Tumors, blood clots, neurogenic causes.
  • Extrinsic
Pregnancy, local inflammation, endometriosis, local tumors
Sclerosing retroperitoneal fibrosis
  • Adults 40+
  • Usually idiopathic; others associated with ergot derivatives, beta blockers, adjacent inflammation, local tumors
  • Associated with mediastinal fibrosis, sclerosing cholangitis, Riedel thyroiditis
  • Associated with the spectrum of IgG4 associated disease
  • Fibrous tissue with infiltrate of IgG4-positive plasma cells, and other inflammatory cells
  • Clinical features: Pain (Lower back, abdomen), obstructive uropathy
  • Diagnosis: Image, biopsy
  • Treatment: Relieve obstruction (stents, etc), stop fibrotic process (glucocorticoids, etc)
Ureteritis cystica
  • Benign
  • Multiple small submucosal cysts, not communicate with ureter lumen
  • Associated with diabetes, with recurrent urinary tract infection
  • More common in women and older patients
  • Multiple filling defects in image studies
  • Higher risk for urothelial carcinoma
Ureter fibroepithelial polyp
  • Uncommon, usually children or young adult men
  • Hematuria and obstructive urinary symptoms
  • Polypoid projection of edematous/vascular stroma with overlying urothelial lining
Ureter urothelial carcinoma
  • Most common ureter carcinomas
  • Most patients are women, age 50+, non-white
  • May be associated with Lynch Syndrome
  • Obstruction, causing hydronephrosis
  • May be multiple, with concurrent tumors in other loci of urinary tract


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