The pain in the lateral thigh and pubic regions continues to be intense and unremitting. The patient is admitted to the hospital for observation and possible surgical intervention. Given this paicular pattern of renal colic and the anatomy of the renal system, it is suspected that a stone has stopped moving and is lodged.
The ureters narrow at the renal pelvis, at the pelvic brim, where they cross the iliac vessels and enter the deep pelvis, and at the urinary bladder. Thus, the probability of a nephrolith lodging in the ureter at the pelvic brim is high and is confirmed by the pattern of referred pain.
At the junction of the renal pelvis and ureter
Midureter as it passes beneath the gonadal vessels
At the pelvic brim
In the intramural poion of the ureter where it penetrates the bladder