Ureteric obstruction associated with uterine prolapse.

14 cases of ureteric obstruction in patients with uterine prolapse are presented. The clinical, radiological, endoscopic and surgical observations are considered and discussed. Ureteric dilatation develops in two successive stages each of which has a different mechanism. In the first stage, stretching of the terminal ureter leads to a fusiform and gradual dilatation. In the second more advanced stage, caudal and posterior displacement of the trigone and bladder base leads to a rotation of the intramural ureter forming a sharp angle with the juxtavesical ureter, causing further ureteric obstruction. These observations emphasize the importance of urographical evaluation in patients with uterine prolapse.