UreteritisIntroduction: Infections
of the ureter technically would be called "ureteritis", although most
physicians prefer to use the term UTI, which is the short form of "urinary
tract infection". The ureter rarely is infected alone, but there is either
a pyelonephritis or a cystitis associated with it. In fact, often the whole urinary
tract gets infected. Still, it makes sense to conceptually separate the ureter
from the rest of the urinary tract, because there are some peculiar anatomical
abnormalities that can give rise to recurrent infections starting there. In
fetal life there are two ureters on each side, so that a duplication of the ureter
on each side is possible and sometimes only half of a ureter is duplicated, but
ends up in a blind loop. Any of those congenital anatomical abnormalities can
be a cause of infection. A stenosis is a narrowing of the ureter and this can
be congenital. Also a tortuous piece of ureter or a missing valve mechanism
in the lower end (ureter/bladder junction) leading to reflux of urine from the
bladder into the ureter, can be found as congenital abnormalities in children
and adults who have frequent UTI's. Certain neurological complications of diseases
like multiple sclerosis, Lou Gehrig disease, diabetic neuropathy, stroke, spasticity
and others can lead to urine transportation problems through the ureter and the
bladder leading to spastic or atonic bladder. Frequent UTI's with problem bugs
like Pseudomonas, Proteus or Klebsiella can be very frustrating for the physician
to treat. Other causes of UTI's in the ureter can be cancer of the lining of the
ureter, a kidney stone that has migrated into the ureter or trauma (accidental
cutting during pelvic surgical procedures such as hysterectomies, or gun shot
wounds). All of these various condition tend to cause chronic recurrent UTI's
(Ref.2,p.227). Signs and symptoms: The symptoms depend
very much on what the underlying cause of ureter infection is. For instance, with
a kidney stone the symptoms are
much more due to the renal colic and maybe small ureter laceration from the stone
leading to blood in the urine. The fever and frequent urination, which would be
part of the urinary tract infection, is more in the background. On the other hand
a history of blood in the urine and weight loss in association with a UTI may
point to a cancer of the ureter. Often the only pointer that something is not
right is the fact that a person gets frequent recurrent urinary tract infections.
Congenital abnormalities such as a tortuous ureter , a duplicated ureter system,
a diverticle or other abnormalities are often picked up in the process of a workup
for recurrent UTI's. The tests are similar to the ones described above for pyelonephritis.
Treatment: The objective of the treatment is to
treat the infection until urine is sterile and at the same time to correct the
underlying cause. In the case of a duplication of the ureter system, the
urologist may decide to remove a dead end piece, where no urine flows through,
but in another case the specialist may decide to leave it alone. A cancer has
to mostly be eradicated with fairly invasive surgery, possibly followed by radiotherapy
or chemotherapy. Antibiotics are used according to sensitivity tests in the lab.
If there is a reflux problem at the ureter/bladder junction from a congenital
problem with the valve, a ureter revision and implantation has to be done by the
urologist to solve the problem. In some cases where the underlying problem cannot
be fixed, the specialist may decide to put the patient on continuous low dose
sulfonamide antibiotics. Pain relief: There is an FDA approved
non-drug method available, IceWave
patches from Lifewave, which will control pain. This is mentioned in the
book "Breakthrough" by Suzanne Somers (Ref. 6) where newer insights
of antiaging medicine are also reviewed. Although the patches are placed over
acupuncture points, there are no needles involved. Nanotechnology, a newer technology,
was used in the manufacturing of these patches and infrared (heat) waves from
body heat are utilized to stimulate an acupuncture point, which modifies pain
perception and reduces pain to half or less. Medically this would be considered
an excellent pain reliever. For more info on the patches see the IceWave patches
from Lifewave link above (click "products"). In the US a 5 pack of the
IceWave spray is available that can be directly sprayed onto the skin in the area
where the pain is located. |
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