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Major controversies in urology such as indications for radical prostatectomy for carcinoma do not have quite their equal in disorders of the ureter, but there are many conditions and clinical situations in which there is doubt and disagreement about the cause of symptoms or the best policy of management. At a basic level, what is the mechanism of the production of ureteric colic, spasm or distension? Is reference of pain to the “testis” anything to do with stimulation of the genitofemoral nerve by the ureter? In acute ureteric obstruction should fluid intake be increased, or is it better to reduce the pressure on the kidney by fluid restriction, even by the administration of an antidiuretic such as DDAVP? Provided that the patient is not, for example, an airline pilot, or is planning to be far from urological services, how long should a calculus causing no symptoms and no obstruction and without infection be left in the ureter? What should be the attitude to calculus extraction in the presence of various degrees of active urinary tract infection?
KeywordsRetroperitoneal Fibrosis Ureteric Calculus Genitofemoral Nerve Airline Pilot Idiopathic Retroperitoneal Fibrosis
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