Where is the ureteral tenderness point located?

The tender points of the ureter are mainly divided into three regions: upper, middle, and lower. 1. Upper ureteral tender point: Located at the intersection of a horizontal line through the umbilicus and the lateral border of the rectus abdominis muscle on both sides—specifically, where the umbilical level meets the outer edge of the rectus abdominis. Tenderness in this area may indicate conditions such as stones or infection. 2. Middle ureteral tender point: Found at the junction of a horizontal line connecting the bilateral anterior superior iliac spines and the lateral border of the rectus abdominis muscle—essentially, where the line joining the two hip bones intersects the outer edge of the rectus abdominis. This tender point corresponds to the second physiological narrowing of the ureter. Tenderness here often suggests pathological changes such as infection or calculi in this region. 3. Lower ureteral tender point: Situated within the pelvic cavity, it does not have a clear surface projection and is therefore difficult to palpate. In males, this tender point lies on the anterior rectal wall, above and lateral to the prostate; in females, it is located on the anterolateral aspect of the vaginal fornix.