How does extrinsic compression of the urinary tract cause flank pain?

Updated: Dec 11, 2019
  • Author: Bradley C Gill, MD, MS; Chief Editor: Bradley Fields Schwartz, DO, FACS  more...
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Similar to stricture disease, wihch is an intrinsic obstruction of the urinary tract, almost all portions of the urinary tract are also at risk for extrinsic obstruction. Large pelvic or retroperitoneal masses may directly compress the ureter, impairing renal drainage and leading to proximal dilation of the urinary tract, which causes pain. Retroperitoneal fibrosis is another  common cause of ureteral distortion and obstruction. Endometriosis has also been noted to result in ureteral compression. Finally, iatrogenic compression of the ureter can occur as a result of surgical clips, sutures, or staples placed along the course of the ureter; this highlights the relevance of obtaining an accurate surgical hstory.

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