Normally, the<unk> <unk>  crosses over the ureter at the level of the fourth or fifth lumbar vertebral bone. The ureter itself courses over the external iliac artery and<unk> . Thus, these vessels can impinge on the ureter causing obstruction. The left<unk> <unk>  ends in the renal<unk>  whereas the right<unk> <unk>  normally enters into the inferior vena cava. In the case of right<unk> , the<unk>  often ends in the renal<unk> . This is thought to contribute to venous engorgement, in analogy to what is seen in varicoceles, which arise more commonly on the left side. The straight angle between the<unk> <unk>  (or testicular<unk>  in males in the case of varicocoele) and the renal<unk>  has been proposed as a cause of decreased blood return. A related diagnosis is "Nutcraker<unk> " where the left renal<unk>  is described as being compressed between the aorta and the superior mesenteric artery. This is reported to cause collateral flow paths to open up to drain the left kidney i.e. reversed flow (reflux caudally) in the left renal<unk> . Pelvic Congestion<unk> , vaginal and vulval varices, lower limb varices are clinical sequelae. Virtually all such patient are female and have been pregnant, often multiply. The<unk> <unk>  often displays incompetent valves. This has been observed more often in women with a higher number of previous pregnancies. Pressure from the baby might hinder the return of blood through the<unk> <unk> . It has to be noted however that dilation of the urinary tract is a normal observation in pregnancy, due to mechanical compression and the hormonal action of progesterone.<unk> <unk>  dilatation might also follow venous thrombosis (clotting inside the<unk> . Another proposed mechanism of obstruction is when the<unk> <unk>  and ureter both run through a sheath of fibrous tissue, following a local inflammation. This could be seen as a localised form of retroperitoneal fibrosis. Following obstruction, the ureter displays an abnormal peristalsis (contractions) towards the kidney instead of towards the bladder. This is thought to cause the colicky pain (similar to renal colic), and it is relieved after surgical decompression.
Ovarian vein syndrome
Ovarian torsion
Ovarian apoplexy
Salpingitis
Tubo-ovarian abscess
Ectopic pregnancy
Ovarian cyst
PELVIS syndrome