<prompt> Ureteric colic due to stone is caused byStretching of renal capsule due to back pressureIncreased peristalsis of ureter to overcome the obstructionIrritation of intramural ureterExtravasation of urine  <response>: Increased peristalsis of the ureter to overcome obstruction 31-Smith Urology 17th,1274-Baily Love 25thThe severity and colicky nature of ureteric colic pain are caused by the hyper peristalsis and spasm of smooth muscles of the ureter as it attempts to rid itself of a foreign body or to overcome obstruction smith urology 17thPain from acute obstruction of ureterStone or Blood clot Back Pain Severe colicky painThis results from capsular distensionThis results from renal, pelvic and ureteral muscle spasm. The severity and colicky pain are caused by the hyperperistalsis and spasm of this smooth muscle organ Ureter as it attempts to rid itself of a foreign body or to overcome obstruction Pain classically radiates from costovertebral angle down towards the lower anterior abdominal quadrant In Men - It may also be felt in the bladder, scrotum or testicle In women - it may also be felt in the vulvaLocation of Ureteric Pain Stone in upper ureter - Pain radiates to testicles T11T12 Nerve supply of testicles is similar to that of kidney upper ureter Stone in the midportion of ureteri Right side - Pain referred to Me Burneys point and stimulates appendicitis T12L1ii Left side - Pain referred to left lower quadrant and stimulates diverticulitis or other disease of the descending or sigmoid colon T12-L1 Stone in the lower portioni Proximal to orifice - Pain is referred to inner side of thigh or groin L1 L2ii At the level of orifice or orifice involved due to edema symptoms of vesical irritability such as frequency and urgency may occur Ureteric peristalsis is due to intact supply of - Intrinsic smooth muscle pacemaker activity of renal calyces The narrowest part of ureter is at the - uretero-vesical junction Highest incidence of ureteric injury in- Wertheims hysterectomyUreteric Constriction - Sitesi. Ureteropelvic junctionii. Crossing of the iliac arteryiii. Juxta position of the vas deferens or broad ligamentiv. Uretero vesical junctionv. Ureteric orifice Phosphate stones Staghorn calculiExcess alkali consumption, Alkali urineInfection with urease splitting organism eg Proteus, kleibsella, Pseudomonas Cystine stoneForm in acidic urine, Extremely hard stone,Relatively resistant to fragmentation with ESWLThe most sensitive imaging modality for diagnosis ureteric stone in a patient with acute colic is - Non contrastCT scan of the abdomenArterial supply of ureter are as followsa upper endb Middle portionc PelvisRenal arteryTesticular or ovarian arterySuperior vesical artery 