ureteritis
Introduction
Introduction to ureteritis Ureteritis is inflammation of the unilateral or bilateral ureter, which is an inflammatory lesion of the ureteral wall caused by pathogenic bacteria such as Escherichia coli, Proteus, Pseudomonas aeruginosa (Pseudomonas aeruginosa) and Staphylococcus. Often secondary to infections in other parts of the urinary system, endogenous or exogenous. The spread of kidney or bladder infections is the most common cause. Another reason is the urinary flow delay caused by partial ureteral innervation defects (urinary flow pause). Potential kidney or bladder infections require treatment, and ureteral segments with innervation defects require surgical resection. basic knowledge The proportion of illness: 20% Susceptible people: no special people Mode of infection: non-infectious Complications: urinary tract obstruction
Cause
Causes of ureteritis
(1) Causes of the disease
Ureteral inflammation often secondary to pyelonephritis, cystitis, etc., may also be caused by blood or lymphatic spread and the spread of adjacent organ infections (such as appendicitis, ileitis, peritonitis, etc.); some patients due to medical device examination, urethral stone friction and Caused by drugs.
(two) pathogenesis
Acute ureteritis is mainly characterized by mucosal suppurative inflammation, while chronic can be characterized by dilatation of the ureteral wall, thinning, and the duct is gradually elongated in a spiral shape. It can also be characterized by thickening of the ureteral wall, hardening, stiffness, and degeneration of myometrial fibers. , resulting in total ureteral stricture leading to hydronephrosis.
Prevention
Ureteritis prevention
(1) insist on drinking plenty of water:
The urine excreted by the kidneys acts as a flushing action on the bladder and urethra, which is beneficial to the discharge of bacteria. Drinking plenty of water every day, urinating once every 2 to 3 hours, can avoid the proliferation of bacteria in the urinary tract, and can reduce the incidence of urinary tract infections. This is the most practical and effective way to prevent urinary tract infections. In the stage of the onset or remission of the disease, drinking plenty of water every day is also conducive to the recovery of the disease. Tea drinking or light bamboo leaves also have a certain preventive effect.
(2) Pay attention to personal hygiene:
Female genitals and urethra are home to a large number of bacteria, which is a prerequisite for urinary tract infections. Therefore, always pay attention to the cleansing of the genitals, to take a bath, and do not use pool baths or baths, you should change underwear frequently, especially in the wedding, menstruation, pregnancy and puerperium. The baby girl has to change the diaper.
(3) Try to avoid using urinary tract infection devices and intubation:
Urinary tract instruments are easy to bring bacteria at the distal end of the urethra into the bladder and upper urinary tract. Continuous bacteriuria is prone to occur after urinary intubation. Therefore, it should be avoided. When it is necessary to use it, it should be strictly disinfected. After 48 hours of use of the urinary tract device, urine culture should be used to observe whether a urinary tract infection occurs. Before using urinary tract instruments, patients with bacterial urine should control infection first. Some patients had no bacterial urine at the time, but had a history of recurrent urinary tract infections or urinary tract abnormalities. Antibiotics should be taken at the urinary tract examination or 48 hours before and after to prevent infection. In the first three days of indwelling catheterization, administration of an antibacterial agent can prevent or delay the occurrence of urinary tract infection, but administration after 3 days has no preventive effect. In addition, the closed drainage system is connected to the urinary indwelling catheter, which can significantly reduce the incidence of urinary tract infection.
Complication
Ureteritis complications Complications, urinary tract obstruction
The disease can cause upper urinary tract obstruction due to ureteral stricture.
Symptom
Symptoms of ureteritis common symptoms ureteral stenosis hypertrophic ureteral cyst urinary urinary frequency ureteral urinary pain kidney area snoring pain urinary tract infection waist acid and urine
Mainly manifested as frequent urination, urgency, dysuria, accompanied by backache, low back pain, severe symptoms of hematuria, fever, etc., when caused by severe hydronephrosis, the kidney area has sputum pain.
Examine
Ureteritis examination
Urine routine examination: white blood cells can be seen, and pathogenic bacteria can be seen in urine culture.
Imaging examination: B-ultrasound can be found in hydronephrosis; IVU can be seen with ureteral dilatation or stenosis, ureteral stiffness and irregular edges.
Diagnosis
Diagnosis and differentiation of ureteritis
diagnosis:
According to the patient's history of urinary tract infection or the history of urethral instrument examination, clinical manifestations and physical examination, combined with laboratory and imaging examination, the diagnosis can be confirmed.
Cystic ureteritis is a lesion of multiple small cysts on the mucosal surface of ureteritis. It is generally considered to be associated with Escherichia coli and diabetes. Its clinical manifestations are similar to those of ureteritis. Occasionally, hematuria, intravenous urinary tract Contrast can be found on the unilateral or bilateral ureteral mucosa surface with smooth small cystic filling defect shadow, more common in the upper 1/3 ureter.
Differential diagnosis:
Ureteral negative stones
Also manifested as low back pain, B-ultrasound showed hydronephrosis. However, patients often have renal colic performance, IVU can be seen with hydronephrosis, and there is a filling defect in the ureter. CT can show stones in the ureter.
Ureteral tumor
Sometimes it can be expressed as low back pain, B ultrasound shows hydronephrosis. However, there is often painless gross hematuria, and IVU shows a filling defect in the ureter. The urine exfoliated cells were positive.
Posterior vena cava ureter
It is characterized by low back pain on the right side and B-ultrasound showing hydronephrosis. IVU can show the upper ureteral dilatation and shift to the midline, and the ureter can be seen as "S" in the whole process. If the obstruction is severe, there may be hydronephrosis. CT three-dimensional reconstruction can confirm the diagnosis.
