Inflammation Of Ureter
Ureteritis refers to inflammation of the ureter, it is rare and is often associated with cystitis or pyelonephritis 1.
Contents
- 1 What does inflamed ureter feel like?
- 2 Can UTI cause ureteritis?
- 3 How do you treat a ureter problem?
- 4 How do you know if your ureter is damaged?
- 5 What does a blocked ureter feel like?
What causes inflammation of the ureter?
What is urethritis? – Urethritis is an inflammation (swelling and irritation) of the urethra, the tube that takes urine (pee) from your bladder to the outside of your body. Typically, urethritis is caused by an infection. Most commonly, but not always, the cause is a sexually transmitted infection (STI).
What is the medical term for inflammation of the ureter?
Ureteritis is a medical condition of the ureter that involves inflammation. One form is known as ‘ureteritis cystica’.
How do you diagnose ureteritis?
Is a differential diagnosis necessary in a patient with ureteritis cystica? a Department of Urology, School of Medicine (FAMERP/FUNFARME), São José do Rio Preto, SP, Brazil Find articles by b Graduate Student in Medicine, Medical School of Catanduva (UNIFIPA), Catanduva, SP, Brazil Find articles by a Department of Urology, School of Medicine (FAMERP/FUNFARME), São José do Rio Preto, SP, Brazil Find articles by a Department of Urology, School of Medicine (FAMERP/FUNFARME), São José do Rio Preto, SP, Brazil Find articles by
a Department of Urology, School of Medicine (FAMERP/FUNFARME), São José do Rio Preto, SP, Brazil b Graduate Student in Medicine, Medical School of Catanduva (UNIFIPA), Catanduva, SP, Brazil c Urologist, Hospital de Base of São José do Rio Preto, SP, Brazil d General Physician, São José do Rio Preto, SP, Brazil Luís Cesar Fava Spessoto:
∗ Corresponding author. Department of Urology, São José do Rio Preto Medical School, Ave. Fernando C. Pires, 3600, São José do Rio Preto, São Paulo, Brazil. Received 2020 Jul 11; Revised 2020 Aug 4; Accepted 2020 Aug 7. © 2020 The Authors This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
- Ureteritis cystica is a rare urological disease with an undefined etiology.
- Despite the benign behavior, the differential diagnosis should be investigated, as other conditions the cause filling defects in the ureters may occur.
- We present a rare case of a patient with ureteritis cystica whose differential diagnosis was satisfactory.
Keywords: Diagnosis, Endourology, Ureteritis cystica Ureteritis cystica is a rare urological disease with an undefined etiology. It is generally benign and often associated with chronic inflammatory injury of the urothelium. The diagnosis can be performed by computed tomography or magnetic resonance, which reveal filling defects in the ureters.
- However, it can also be an incidental finding during ureteroscopy.
- Despite the benign behavior, the differential diagnosis should be investigated, as other conditions the cause filling defects in the ureters may occur.
- We present a rare case of a patient with ureteritis cystica whose differential diagnosis was satisfactory.
A 69-year-old female patient visited the clinic with a history of recurring urinary infection and left renal lithiasis with a surgical indication for flexible trans -ureteroscopic ureterolithotripsy. Computed tomography revealed filling defects in the ureter ().
After the preoperative cardiological evaluation and the determination of the absence of urinary infection, the patient was submitted to rigid ureteroscopy, which revealed several lesions with a cystic appearance and pearly color of varied sizes throughout the entire length of the ureter (). The lesions were biopsied and sent for histopathologic examination.
Biopsy specimens were negative for malignancy and the condition was diagnosed as ureteritis cystica (). The patient was then submitted to endoscopic treatment of the kidney stone and was discharged from hospital the following day with no symptoms. Ureteritis cystica is more prevalent in older women, which is in agreement with the demographic characteristics of the present case.
- Although its etiology is unknown, certain factors are associated with ureteritis cystica, such as urinary infection and kidney stones, which are chronic aggressors of the urothelium.
- In the present case, the patient had a history of lower urinary tract infection and had a kidney stone, which may have contributed to the emergence of this condition.
Despite the benign nature of ureteritis cystica, other conditions can also cause filling defects in the ureters, such as transitional cell carcinoma, blood clots, air bubbles, calculi, polyps and urinary tuberculosis. Therefore, the differential diagnosis is needed to determine the best treatment option.
- The differential diagnosis is needed to determine the best treatment option.
- As this disease is silent and the patient is asymptomatic, treatment should be conservative.
- This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.1.
- He Y.R., Kam J., Chan H.F.
A rare case of extensive unilateral ureteritis cystica. Urology.2020; 138 :e3–e4.2. Navas Pastor J., Morga Egea J.P., García Ligero J. Arch Esp Urol.2000; 53 (1):15–20.3. Padilla-Fernández B., Díaz-Alférez F., Herrero-Polo M. Ureteritis cystica: important consideration in the differential diagnosis of acute renal colic.
- Clin Med Insights Case Rep.2012; 5 :29–33.4.
- Ilic S., Sargin S.Y., Gunes A.
- A rare condition: the ureteritis cystica: a report of two cases and review of literature.M.T.
- Altinok İnönü Üniversitesi Tıp Fakültesi Dergisi.2003:87–89.5.
- Neretljak I., Orešković J., Šktrić A., Kavur L., Sučić M.
- Ureteritis cystica: a rare urological condition.
Urol Case Rep.2019; 24 :100866. Articles from Urology Case Reports are provided here courtesy of Elsevier : Is a differential diagnosis necessary in a patient with ureteritis cystica?
What is ureteritis cystitis?
Ureteritis cystica – A rare urological condition a Department of Urology, University Hospital Merkur, Zagreb, Croatia Find articles by a Department of Urology, University Hospital Merkur, Zagreb, Croatia Find articles by b Department of Pathology, University Hospital Merkur, Zagreb, Croatia Find articles by c Department of Radiology, University Hospital Merkur, Zagreb, Croatia Find articles by a Department of Urology, University Hospital Merkur, Zagreb, Croatia Find articles by Received 2019 Feb 14; Revised 2019 Mar 9; Accepted 2019 Mar 13.
© 2019 The Authors This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Ureteritis cystica is a rare benign condition. In this report, we have presented the case of a patient with a left upper back pain. The CT scan showed multiple irregular filling defects in the upper left ureter and the left renal pelvis.
During the ureteroscopy, multiple yellow cystic lesions were seen in the proximal part of the left ureter and in the renal pelvis. The pathology report described cystic structures coated with single line cubic metaplastic epithelium. Ureteritis cystica should be considered in a differential diagnosis, in case of atypical radiological findings.
No active treatment is required when confirmed. Keywords: Ureteritis cystica, Cystitis cystica, Ureter Ureteritis cystica is a rare benign condition that affects the ureter and the renal pelvis. The condition was first reported by Morgagni in the 18th century. The first to describe it were Richmond and Robb, as a proliferation characterized by multiple cyst and filing defects in the urothelium.
The etiology of the disease is not known, but it is associated with chronic urothelial irritation that can be caused by nephrolithiasis and urinary tract infections. Histologically, there are numerous small submucosal epithelial-lined cysts representing cystic degeneration of the metaplastic epithelium or the submucosal Brunn cell nests.
Their walls are transparent macroscopically and the fluid contained within is mucoproteinacous. There is often a surrounding infiltrate of lymphocytes. Radiographically, the appearance is that of multiple small 2–5 mm smooth, walled, rounded, lucent filling defects projecting into the lumen, usually of the ureter.
They are most common in the proximal ureter, but can be seen anywhere along the urinary tract: bladder (cystitis cystica) or renal pelvis (pyelitis cystica). A differential diagnosis of multiple transitional cell tumors, ureteral pseudodiverticula, nonopaque calculi, polyps, papillary tumors, vascular impressions, tuberculosis, iatrogenic gas bubbles, gas-forming microorganisms, and submucosal hemorrhage can be considered with an appropriate clinical correlation.
A 70-year-old female patient was admitted in office due to left upper back pain which was not severe. The patient had a history of kidney stones. Four and two years ago she passed 4mm and 5mm stone after having severe left flank pain. A urinalysis was within normal limits. The blood count and serum creatinine were within normal limits.
An abdominal roentgenogram showed no abnormal calcifications. Voided urinary cytology was negative for malignant cells. The ultrasound showed no kidney stones and no dilatation of the renal pelvis. There were multiple renal parapelvic cysts on both kidneys.
A CT scan was performed. It confirmed multiple renal parapelvic cysts, up to 2.7 cm in diameter. It also showed multiple irregular filling defects, up to 2mm, in the upper left ureter and the left renal pelvis (). The ureters were not dilated. Many differential diagnosis were considered (multiple transitional cell tumors, papillary tumors, tuberculosis).
Our main concern was to rule out malignant lesions so we performed explorative cystoscopy and ureteroscopy. Explorative cystoscopy showed a normal bladder neck. Ureteral orifices were of normal size, shape and position, effluxing clear bilaterally. The bladder mucosa was normal.
- The left ureteral orifice was easily identified and a ureteroscope was introduced into the ureter.
- During the ureteroscopy, multiple yellow cystic lesions were seen in the proximal part of the left ureter and in the left renal pelvis ().
- One of the cysts was punctured.
- Milky and cloudy fluid drained from the cyst.
The material was collected for cytological evaluation. The second cyst was punctured and its wall was collected for pathological evaluation. The pathology report described cystic structures coated with single line cubic metaplastic epithelium most consistent with cystitis cystica ().
Ureteritis cystica is a rare benign condition that affects the ureter and the renal pelvis. It is usually detected incidentally on a CT or an MR scan during imaging for other reasons, like an unexplained finding of filling defects in the ureters. The most common location of cystic lesions is the proximal ureter but they can be found at any level of the urothelium.
In this case, the renal pelvis was also affected with the proximal ureter. The patient had a history of kidney stones. The CT scan was performed because of the upper back pain. It is possible that the cause of the flank pain might have been an undiagnosed ureteral stone which had been spontaneously expelled prior to radiographic workup rather than the cystic leasons themselves and the diagnosis of urethritis cystica was an incidental finding.
- The diagnosis was confirmed by ureteroscopy and the pathological report.
- In case of recurrent flank pain in this patient that is not severe and with no ultrasound dilatation of renal calycs we would treat her with non-steroidal anti-inflammatory drugs.
- Since the patient has kidney stone history in case of recurrent flank pain that is severe and non-responsive to analgesic therapy we would perform non-contrast low dose CT scan to rule out ureteral/renal stone.
Urethritis cystica is associated with chronic urothelial irritation that can be caused by nephrolithiasis (as was in our case) and urinary tract infections. There are no guidelines for the management of ureteritis cystica apart from the treatment of the underlying cause.
- Ureteritis cystica should be considered as a differential diagnosis in case of atypical radiological findings.
- No active treatment is required when confirmed.
- Consent for publication: Written informed consent for publication of clinical details and images was obtained from the patient.
- This research did not receive any specific grants from funding agencies in the public, commercial or not-for-profit sectors.1.
Morgagni J.B. William Cooke Translation; 1822. De sedibus et causis morborum per anatomen indagatis libri quinque; pp.316–411.2. Richmond H.G., Robb W.A. Adenocarcinoma of the ureter secondary to ureteritis cystica. Br J Urol.1967; 39 :359–363.3. Kilic S., Sargin S.Y., Gunes A.
- A rare condition: the ureteritis cystica.
- A report of two cases and review of literature.M.T.
- Altinok İnönü Üniversitesi Tıp Fakültesi Dergisi.2003:87–89.4.
- Rothschild J.G., Wu G.
- Ureteritis cystica: a radiologic pathologic correlation.
- Journal of Clinical Imaging Science.2011; 23 5.
- Menendez V., Sala X., Alvarez-Vijande R.
Cystic pyeloureteritis: review of 34 cases. Radiologic aspects and differential diagnosis. Urology.1997; 50 :31. Articles from Urology Case Reports are provided here courtesy of Elsevier : Ureteritis cystica – A rare urological condition
What does inflamed ureter feel like?
Urethritis is inflammation of the urethra. That’s the tube that carries urine from the bladder to outside the body. Pain with urination is the main symptom of urethritis. Urethritis is commonly due to infection by bacteria, most often through sexual contact.
Gonococcus, which is sexually transmitted and causes gonorrhea, Chlamydia trachomatis, which is sexually transmitted and causes chlamydia,Bacteria in and around stool.
The herpes simplex virus (HSV-1 and HSV-2) can also cause urethritis. Trichomonas is another cause of urethritis. It is a single-celled organism that is sexually transmitted. Sexually transmitted infections like gonorrhea and chlamydia are usually confined to the urethra.
- But they may extend into women’s reproductive organs, causing pelvic inflammatory disease (PID).
- In men, gonorrhea and chlamydia sometimes cause epididymitis, an infection of the epididymis, a tube on the outside of the testes.
- Both PID and epididymitis can lead to infertility,
- The main symptom of urethra inflammation from urethritis is pain with urination ( dysuria ).
In addition to pain, urethritis symptoms include:
Feeling the frequent or urgent need to urinateDifficulty starting urination
Urethritis can also cause itching, pain, or discomfort when a person is not urinating. Other symptoms of urethritis include:
Pain during sexDischarge from the urethral opening or vaginaIn men, blood in the semen or urine
You may get a diagnosis of urethritis when your doctor takes your medical history and asks you about your symptoms. If you are having painful urination, your doctor may assume an infection is present. They may treat it with antibiotics right away while waiting for test results. Tests can help confirm the diagnosis of urethritis and its cause. Tests for urethritis can include:
Physical examination, including the genitals, abdomen, and rectumUrine tests for gonorrhea, chlamydia, or other bacteriaExamination of any discharge under a microscope
Blood tests are often not necessary for the diagnosis of urethritis. But blood tests may be done in certain situations. Antibiotics can successfully cure urethritis caused by bacteria. Many different antibiotics can treat urethritis. Some of the most commonly prescribed include:
Adoxa, doxycycline ( Vibramycin ), Monodox, Oracea Azithromycin ( Zmax ), Zithromax Ceftriaxone ( Rocephin )
Urethritis due to trichomonas infection (called trichomoniasis ) is usually treated with an antibiotic called metronidazole (Flagyl). Tinidazole ( Tindamax ) is another antibiotic that can treat trichomoniasis. Your sexual partner should also be treated to prevent reinfection.
Acyclovir ( Zovirax ) Famciclovir ( Famvir ) Valacyclovir (Valtrex)
Often, the exact organism causing urethritis cannot be identified. In these situations, a doctor may prescribe one or more antibiotics that are likely to cure infection that may be present.
Can a ureter heal on its own?
Pathophysiology – The pathophysiology of ureteral injury depends on many factors, including the type of injury and when the injury is identified. Although spontaneous resolution and healing may occur, ureteral injuries may have numerous consequences, including the following:
- Urinary extravasation due to ureteral necrosis or unrecognized complete or partial transection
- Ureteral stricture formation
How do you treat a swollen ureter?
Treating the underlying cause – Once the pressure on your kidneys has been relieved, the cause of the build-up of urine may need to be treated. Some possible causes and their treatments are described below:
kidney stones can be removed during an operation or broken up using sound waves – read more about treating kidney stones an enlarged prostate can be treated with medication or surgery to remove some of the prostate – read more about treating prostate enlargement narrowing of the ureter (the tube that runs from the kidney to the bladder) can be treated by inserting a hollow plastic or metal tube called a stent, which allows urine to flow through the narrowed section – this can often be done without making cuts in your skin cancer that’s causing hydronephrosis may be treated using chemotherapy, radiotherapy or surgery to remove the cancerous tissue
If hydronephrosis happens because you’re pregnant, you will not usually need any treatment because the condition will pass within a few weeks of giving birth. In the meantime, catheters can be regularly used to drain urine from the kidneys. Painkillers and antibiotics can also be given if you’re in pain or develop a UTI.
Can UTI cause ureteritis?
Both bacteria and viruses may cause urethritis. Some of the bacteria that cause this condition include E coli, chlamydia, and gonorrhea. These bacteria also cause urinary tract infections (UTIs) and some sexually transmitted diseases. Viral causes are herpes simplex virus and cytomegalovirus.
How do you treat a ureter problem?
Drainage procedures – A ureteral obstruction that causes severe pain might require an immediate procedure to remove urine from your body and temporarily relieve the problems caused by a blockage. Your doctor (urologist) may recommend:
A ureteral stent, which is a hollow tube inserted inside the ureter to keep it open. Percutaneous nephrostomy, during which your doctor inserts a tube through your back to drain the kidney directly (percutaneous nephrostomy). A catheter, which is a tube inserted through the urethra to connect the bladder to an external drainage bag. This may be especially important if problems with your bladder also contribute to poor drainage of your kidneys.
Your doctor can tell you which procedure or combination of procedures is best for you. Drainage procedures might provide temporary or permanent relief, depending on your condition.
How do you know if your ureter is damaged?
Evaluation – If a surgical drain is present, the fluid can be sent for spot creatinine. Spot creatinine will usually be 25-450 mg/dL when the fluid is urine, but it will be similar to the serum creatinine when it is not urine. A basic metabolic panel should be ordered to evaluate kidney function.
- Elevated BUN/creatinine would raise suspicion for some disruption to the collecting system, preventing drainage of urine.
- Imaging studies are the most important diagnostic tools available to evaluate for ureteral injury.
- A retrograde pyelogram (RPG) is the most accurate imaging test to evaluate the location and extent of the ureteral injury.
Antegrade pyelogram also can be performed if the patient has antegrade access. A CT urogram (CT abdomen and pelvis with IV contrast and delayed images) can accurately identify ureteral injury. Other findings on CT imaging studies that may raise suspicion for ureteral or renal pelvis injury include perinephric stranding, low-density fluid around the kidney and ureters, perinephric hematoma, ureteral dilation or deviation, and incomplete visualization of the entire ureter.
When a CT or intravenous urogram is inconclusive, and ureteral injury is suspected, an RPG must be obtained. Surgical exploration of the retroperitoneum and direct visualization of the ureter is the most accurate method to identify ureteral injury. Inspection of the ureter should involve mobilization of the ureter and visualization of the entire wall for evidence of contusion, hemorrhage, or disruption.
Extravasation of urine confirms the presence of ureteral injury. The viability of the ureter may be compromised when the ureter is murky, discolored, or without capillary refill. A dye study using indigo carmine or methylene blue can be administered by intravenous infusion an aid in direct visualization of ureteral injury.
Can urethra be inflamed without infection?
Summary. Non-specific urethritis (NSU) is inflammation of a man’s urethra that is not caused by gonorrhoea (a sexually transmissible infection). Symptoms of NSU can be very mild and may be overlooked. Untreated NSU can have serious complications.
Is ureteritis an upper or lower UTI?
Diagnostic hallmarks of urinary tract infection Urinary Tract Infection (UTI) is among the leading causes for treatment in adult primary care medicine and represents a significant proportion of antibiotic prescriptions. A UTI can involve any part of the urinary system, including the lower urinary tract – urethra (urethritis) and bladder (cystitis) – and the upper urinary tract – ureters (ureteritis) and kidneys (pyelonephritis).
- UTI impacts both genders, however, women are much more vulnerable due to their anatomy and reproductive physiology.
- Escherichia coli accounts for about 80-85 percent of all UTIs, followed by Staphylococcus species, accounting for 10-15 percent.
- Other bacterial pathogens – including Klebsiella, Pseudomonas, Proteus, and Enterococcus species – are also infrequently implicated.
More rarely, infections may be from fungal or viral pathogens that would require alternative treatment strategies.1 Further sub-classifications of UTIs are based on location of the infection, presence or absence of symptoms, and the presence of relevant complicating factors that dramatically increase the patient risk profile.
How can you tell the difference between cystitis and urethritis?
Unlike cystitis, urethritis resulting from infection is often caused by sexually transmitted organisms and urethritis is a sign of a sexually transmitted disease such as chlamydia or gonorrhea. Cystitis is an infection of the urinary bladder usually caused by bacteria that inhabit the rectum and G.I. tract.
How long can urethral inflammation last?
In most cases, the symptoms should resolve in a week or two and you should not need further treatmentIf you have had sex or did not take the medication as directed, or have persistent symptoms for longer than two weeks, you should consult a doctor.
How can I relax my ureter?
Treating small stones with mild symptoms – To treat small stones that aren’t causing you too much difficulty, your doctor may recommend the following:
Drinking water – It is important to drink plenty of fluids when you have kidney or ureteral stones. Most doctors recommend about 2 to 3 liters of water per day (one half to two-thirds of a gallon). This is meant to flush your urinary tract system. Talk with your doctor about how much fluid you should be drinking and whether any of that fluid can be in a form other than plain water. Taking pain relievers – Because passing even small stones can cause pain, your doctor may recommend over-the-counter pain relievers, such as acetaminophen (Tylenol), ibuprofen (Motrin, Advil) or naproxen sodium (Aleve) to help you manage the pain and discomfort. Taking medications to help you pass the stones – Your doctor may recommend a medication called an alpha blocker to help you pass your kidney stones. It helps relax the muscles in your ureter, which should reduce pain and help you pass the stone more quickly.
Can a ureter infection be fatal?
Introduction – Urinary tract infections (UTIs) are among the most common causes of sepsis presenting to hospitals. UTIs have a wide variety of presentations. Some are simple UTIs that can be managed with outpatient antibiotics and carry a reassuring clinical course with almost universal good progress.
On the other end of the spectrum, florid urosepsis in a comorbid patient can be fatal. UTIs can also be complicated by several risk factors that can lead to treatment failure, repeat infections, or significant morbidity and mortality with a poor outcome. It is vitally important to determine if the presenting episode results from these risk factors and whether the episode is likely to resolve with first-line antibiotics.
It is important to properly define a complicated UTI as an infection that carries a higher risk of treatment failure. These typically require longer courses of treatment, different antibiotics, and sometimes additional workup. In a clinical context that is not associated with treatment failure or poor outcomes, a simple UTI (or simple cystitis) is an infection of the urinary tract due to appropriate susceptible bacteria.
- Typically this is an infection in an afebrile non-pregnant immune-competent female patient.
- Pyuria and/or bacteriuria without any symptoms is not a UTI and may not require treatment.
- An example would be a patient with a Foley catheter or an incidental positive urine culture in an asymptomatic, afebrile non-pregnant immune-competent female.
A complicated UTI is any urinary tract infection other than a simple UTI as defined above. Therefore, all urinary tract infections in immunocompromised patients, males, and those associated with fevers, stones, sepsis, urinary obstruction, catheters, or involving the kidneys are considered complicated infections.
- The normal female urinary tract has a comparatively short urethra and, therefore, carries an inherent predisposition to proximal seeding of bacteria.
- This anatomy increases the frequency of infections.
- Simple cystitis, a one-off episode of ascending pyelonephritis, and occasionally even recurrent cystitis in the proper context can be considered a simple UTI, provided there is a prompt response to first-line antibiotics without any long-term sequela.
Any urinary tract infection that does not conform to the above description or clinical trajectory is considered a complicated UTI. In these scenarios, one can almost always find protective factors that failed to prevent infection or risk factors that lead to poor resolution of sepsis, higher morbidity, treatment failures, and reinfection.
- The reason for the distinction is that complicated UTIs have a broader spectrum of bacteria as an etiology and have a significantly higher risk of clinical complications.
- The presence of urinary tract stones and catheters is likely to increase the incidence of recurrences compared to patients without these foci of bacterial colonization.
Examples of a complicated UTI include:
Infections occurring despite the presence of anatomical protective measures (UTIs in males are by definition considered complicated UTIs) Infections occurring due to anatomical abnormalities, for example, an obstruction, hydronephrosis, renal tract calculi, or colovesical fistula Infections occurring due to an immune-compromised state, for example, steroid use, post-chemotherapy, diabetes, elderly population, HIV) Atypical organisms causing UTI Recurrent infections despite adequate treatment (multi-drug resistant organisms) Infections are occurring in pregnancy (including asymptomatic bacteriuria) Infections that occur after instrumentation, such as placing or replacement of nephrostomy tubes, ureteric stents, suprapubic tubes, or Foley catheters Infections in renal transplant and spinal cord injury patients Infections in patients with impaired renal function, dialysis, or anuria Infections following surgical prostatectomies or radiotherapy
Can you feel ureter pain?
Not sure what a ureter stone is? You’ve probably heard of kidney stones, or you may know someone who’s had a kidney stone. You may even have experienced one yourself. A ureter stone, also known as a ureteral stone, is essentially a kidney stone. It’s a kidney stone that has moved from the kidney into another part of the urinary tract.
The ureter is the tube that connects the kidney to the bladder. It’s about the same width as a small vein. It’s the most common location for a kidney stone to become lodged and to cause pain. Depending on the size and location, it can hurt a lot, and it may require medical intervention if it doesn’t pass, causes intractable pain or vomiting, or if it’s associated with fever or infection.
Urinary tract stones are fairly common. According to the American Urological Association, they affect almost 9 percent of the U.S. population, This article will take a closer look at ureter stones, including the symptoms, causes, and treatment options.
If you want to know how to prevent these stones, we’ve covered that, too. Kidney stones are clusters of crystals that typically form in the kidneys. But these masses can develop and move anywhere along your urinary tract, which includes the ureters, urethra, and bladder. A ureter stone is a kidney stone inside one of the ureters, which are the tubes that connect the kidneys to the bladder.
The stone will have formed in the kidney and passed into the ureter with the urine from one of the kidneys. Sometimes, these stones are very small. When that’s the case, the stones may pass through your ureter and into your bladder, and eventually pass out of your body when you urinate.
Sometimes, however, a stone can be too large to pass and can get lodged in the ureter. It may block the flow of urine and can be extremely painful. The most common symptom of a kidney or ureter stone is pain. You might feel pain in your lower abdomen or your flank, which is the area of your back just under your ribs.
The pain can be mild and dull, or it can be excruciating. The pain may also come and go and radiate to other areas. Other possible symptoms include:
pain or a burning sensation when you peeblood in your urinefrequent urge to urinatenausea and vomiting fever
If you experience any of these symptoms, call your healthcare provider. Ureter stones are made up of crystals in your urine that clump together. They usually form in the kidneys before passing into the ureter. Not all ureter stones are made up of the same crystals. These stones can form from different types of crystals such as:
Calcium. Stones made up of calcium oxalate crystals are the most common. Being dehydrated and eating a diet that includes a lot of high-oxalate foods may increase your risk of developing stones. Uric acid. This type of stone develops when urine is too acidic, It’s more common in men and in people who have gout, Struvite. These types of stones are often associated with chronic kidney infections and are found mostly in women who have frequent urinary tract infections (UTIs). Cystine. The least common type of stone, cystine stones occur in people who have the genetic disorder cystinuria, They are caused when cystine, a type of amino acid, leaks into urine from the kidneys.
Certain factors can raise your risk of developing stones, This includes:
Family history. If one of your parents or a sibling has had kidney or ureter stones, you may be more likely to develop them, too. Dehydration. If you don’t drink enough water, you tend to produce a smaller amount of very concentrated urine. You need to produce a larger amount of urine so salts will stay dissolved, rather than hardening into crystals. Diet. Eating a diet high in sodium (salt), animal protein, and high-oxalate food may raise your risk of developing stones. Foods high in oxalate include spinach, tea, chocolate, and nuts. Consuming too much vitamin C may also increase your risk. Certain medications. A number of different kinds of medications, including some decongestants, diuretics, steroids, and anticonvulsants, can increase your chance of developing a stone. Certain medical conditions. You may be more likely to develop stones if you have:
a blockage of the urinary tract inflammatory bowel disease gout hyperparathyroidism obesity recurrent UTIs
If you’re having pain in your lower abdomen, or you’ve noticed blood in your urine, your healthcare provider may suggest a diagnostic imaging test to look for stones. Two of the most common imaging tests for stones include:
A computed tomography (CT) scan. A CT scan is usually the best option for detecting stones in the urinary tract. It uses rotating X-ray machines to create cross-sectional images of the inside of your abdomen and pelvis. An ultrasound. Unlike a CT scan, an ultrasound doesn’t use any radiation. This procedure uses high-frequency sound waves to produce images of the inside of your body.
These tests can help your healthcare provider determine the size and location of your stone. Knowing where the stone is located and how big it is will help them develop the right type of treatment plan. Research suggests that many urinary stones resolve without treatment,
- You may experience some pain while they pass, but as long as you don’t have a fever or infection, you might not have to do anything else other than drink high volumes of water to allow the stone to pass.
- Small stones tend to pass more easily.
- However, as one 2017 study notes, size matters.
- Some stones, especially wider ones, do get stuck in the ureter because it’s the narrowest point in your urinary tract.
This can cause severe pain and raise your risk of developing an infection. If you have a larger or wider stone that’s unlikely to be passed on its own, your healthcare provider will likely want to discuss treatment options with you. They may recommend one of these procedures to remove a ureter stone that’s too large to pass on its own.
Ureteral stent placement. A small, soft, plastic tube is passed into the ureter around the stone, allowing urine to bypass the stone. This temporary solution is a surgical procedure that’s performed under anesthesia. It’s low risk but will need to be followed up by a procedure to remove or break up the stone. Nephrostomy tube placement. An interventional radiologist can temporarily relieve pain by placing this tube directly into the kidney through the back using only sedation and a combination of ultrasound and X-ray, This is commonly used if a fever or infection occurs with urinary obstruction from a stone. Shock wave lithotripsy. This procedure uses focused shock waves to break up the stones into smaller pieces, which can then pass through the rest of your urinary tract and out of your body without any extra help. Ureteroscopy. Your urologist will thread a thin tube with a scope into your urethra and up into your ureter. Once your doctor can see the stone, the stone can be removed directly or broken up with a laser into smaller pieces that can pass on their own. This procedure may be preceded by placement of a ureteral stent to allow the ureter to passively dilate over a few weeks before ureteroscopy. Percutaneous nephrolithotomy. This procedure is typically used if you have very large or an unusual-shaped stone in the kidney. Your doctor will make a small incision in your back and remove the stone through the incision with a nephroscope. Although it’s a minimally invasive procedure, you’ll need general anesthesia. Medical expulsive therapy. This type of therapy involves the use of alpha-blocker drugs to help the stone to pass. However, according to a 2018 review of studies, there’s a risk-benefit ratio to consider. Alpha- blockers help lower blood pressure, which can be effective for clearing smaller stones, but it also carries a risk of negative events.
You can’t change your family history, but there are some steps you can take to reduce your chance of developing stones.
Drink plenty of fluids. If you tend to develop stones, try to consume about 3 liters of fluid (approximately 100 ounces) every day. This will help boost your urine output, which keeps your urine from getting too concentrated. It’s best to drink water instead of juices or sodas. Watch your salt and protein intake. If you tend to eat a lot of animal protein and salt, you may want to cut back, Both animal protein and salt can raise the acid levels in your urine. Limit high-oxalate foods. Eating foods that are high in oxalate can lead to urinary tract stones. Try to limit these foods in your diet. Balance your calcium intake. You don’t want to consume too much calcium, but you don’t want to reduce your calcium intake too much because you’ll put your bones at risk. Plus, foods that are high in calcium can balance out high levels of oxalate in other foods. Review your current medications. Talk to your healthcare provider about any medications you’re taking. This includes supplements like vitamin C that have been shown to increase the risk of stones.
A ureter stone is basically a kidney stone that has moved from your kidney into your ureter. Your ureter is a thin tube that allows urine to flow from your kidney into your bladder. You have two ureters — one for each kidney. Stones can develop in your kidney and then move into your ureter.
- They can also form in the ureter.
- If you know you’re at risk of developing kidney stones, try to drink plenty of fluids and watch your intake of animal protein, calcium, salt, and high- oxalate foods.
- If you start to experience pain in your lower abdomen or back, or notice blood in your urine, call your healthcare provider.
Ureter stones can be very painful, but there are several effective treatment options.
What does a blocked ureter feel like?
Urinary tract obstruction is a blockage that inhibits the flow of urine through its normal path (the urinary tract), including the kidneys, ureters, bladder, and urethra.
Blockage can be complete or partial. Blockage can lead to kidney damage, kidney stones, and infection. Symptoms can include pain in the side, decreased or increased urine flow, and urinating at night. Symptoms are more common if the blockage is sudden and complete. Testing can include insertion of a urethral catheter, insertion of a viewing tube into the urethra, and imaging tests. Treatment can include measures to open up a blocked path and to treat the cause of the blockage.
A blockage (obstruction) anywhere along the urinary tract—from the kidneys, where urine is produced, to the urethra, through which urine leaves the body—can increase pressure inside the urinary tract and slow the flow of urine. An obstruction may occur suddenly or develop slowly over days, weeks, or even months.
How do you treat a swollen ureter?
Treating the underlying cause – Once the pressure on your kidneys has been relieved, the cause of the build-up of urine may need to be treated. Some possible causes and their treatments are described below:
kidney stones can be removed during an operation or broken up using sound waves – read more about treating kidney stones an enlarged prostate can be treated with medication or surgery to remove some of the prostate – read more about treating prostate enlargement narrowing of the ureter (the tube that runs from the kidney to the bladder) can be treated by inserting a hollow plastic or metal tube called a stent, which allows urine to flow through the narrowed section – this can often be done without making cuts in your skin cancer that’s causing hydronephrosis may be treated using chemotherapy, radiotherapy or surgery to remove the cancerous tissue
If hydronephrosis happens because you’re pregnant, you will not usually need any treatment because the condition will pass within a few weeks of giving birth. In the meantime, catheters can be regularly used to drain urine from the kidneys. Painkillers and antibiotics can also be given if you’re in pain or develop a UTI.
How do you treat an inflamed urethra?
Symptoms in women – Some symptoms of urethritis in women include:
more frequent urge to urinate discomfort during urinationburning or irritation at the urethral openingabnormal discharge from the vagina may also be present along with the urinary symptoms
People who have urethritis may also not have any noticeable symptoms. This is especially true for women. In men, symptoms may not be apparent if the urethritis developed as a result of chlamydia or occasionally trichomoniasis infection. For this reason, it’s important to undergo testing if you may have been infected with a sexually transmitted infection (STI),
Generally, most cases of urethritis are the result of an infection from either a bacteria or a virus. Bacteria are the most common causes. The same bacteria that can cause bladder and kidney infections can also infect the lining of the urethra. Bacteria found naturally in the genital area may also cause urethritis if they enter the urinary tract.
According to the Centers for Disease Control and Prevention (CDC), bacteria associated with urethritis include:
Neisseria gonorrhoeae Chlamydia trachomatis Mycoplasma genitalium
Pathogens are the biological agents that cause illness. The same pathogens that cause STIs can also cause urethritis. These include the bacteria that cause gonorrhea and chlamydia and the parasite that causes trichomoniasis. There are also viruses that can lead to the development of urethritis.
These include the human papillomavirus (HPV), the herpes simplex virus (HSV), and the cytomegalovirus (CMV). There are different types of urethritis, classified by the cause of the inflammation. They are gonococcal urethritis and nongonococcal urethritis. Gonococcal urethritis is caused by the same bacterium that causes the STI gonorrhea.
It accounts for 20 percent of cases of urethritis. Nongonococcal urethritis is urethritis caused by other infections that are not gonorrhea. Chlamydia is a common cause of nongonococcal urethritis, with other STIs also being a probable culprit. It is possible, however, for irritation unrelated to STIs to occur.
These causes can include injury, such as from a catheter, or other kinds of genital trauma. While plenty of patients have either one type of urethritis or the other, it’s possible to have different causes of urethritis at once. This is especially true in women. Your doctor will ask you about your symptoms.
They’ll likely also examine the genital area for discharge, tenderness, sores and any signs of an STI. This can help them to make a diagnosis. They may order tests to analyze a urine sample or a swab taken from the urethra or vaginal area. If the doctor suspects a specific STI, there will likely be a test that can allow the doctor to confirm or rule out that potential diagnosis.
- Blood tests may be taken to check for other STIs, like HIV and syphilis,
- Depending on your doctor and their lab, you can get test results back in as soon as a few days.
- This allows them to start you on treatment as soon as possible, and to let you know whether your partner needs to be tested and treated, too.
Treatment for urethritis typically includes a course of either antibiotics or antiviral medication. Some common treatments for urethritis include:
azithromycin, an antibiotic, typically taken as a one time dosedoxycycline, an oral antibiotic that is typically taken twice a day for seven dayserythromycin, an antibiotic that can be administered orally, four times a day for seven daysofloxacin, an oral antibiotic that is typically taken twice a day for seven days levofloxacin, an oral antibiotic that is typically taken once a day for seven days
If an STI caused the infection, it’s vital that all sexual partners undergo testing and treatment if necessary. This prevents the spread of the STI and reinfection. You may see improvement in your symptoms just a few days after beginning treatment. You should still finish out your prescription as recommended by your doctor, or the infection could come become worse.
blood-thinning medications heart medications seizure medications
Medication can often treat urethritis quickly. If the infection goes untreated, however, the effects can be lasting and quite serious. For example, the infection may spread to other parts of the urinary tract, including the ureters, kidneys, and bladder.
- These infections can be painful on their own.
- While they can be treated with more intensive rounds of antibiotics, they can cause damage to the organs if left untreated for too long.
- These untreated infections can also spread to the blood and result in sepsis, which can be deadly.
- In addition, the STIs that frequently cause urethritis can damage the reproductive system.
Women may develop pelvic inflammatory disease (PID), which is painful and can result in infertility, ongoing pelvic pain, or pain during sex, Women with untreated STIs are also at a higher risk for ectopic pregnancies, which can be life-threatening.
- Men may develop painful inflammation or infection of the prostate gland, or the narrowing of a section of the urethra due to scarring, leading to painful urination,
- For these reasons, you should speak with a doctor as soon as possible if you notice any symptoms of urethritis.
- Many of the bacteria that cause urethritis can pass to another person through sexual contact.
Because of this, practicing safe sex is an important preventive measure. The tips below can help reduce your risk:
Avoid having intercourse with multiple partners.Use condoms every time you have sex.Get tested regularly.Protect others. If you find out you have an STI, inform others who are also at risk of an infection.
Aside from safer sex practices, there are other ways to promote good urinary tract health. This can lower your risk of urethritis and some other conditions that affect this part of the body. Drink plenty of fluids and make sure to urinate shortly after intercourse. Avoid acidic foods, Also, avoid exposure to spermicides, particularly if you already know they irritate your urethra.