ureterit

Ureteritis is inflammation of the ureter, the muscular tube that transports urine from the kidney to the bladder. It may occur as an isolated inflammatory process or as part of a urinary tract infection, and it can be either acute or chronic. The condition is typically related to infection or irritation from obstruction, but other noninfectious causes such as autoimmune processes or recent instrumentation can also play a role.

Causes and contributing factors include bacterial infection, often arising from a lower urinary tract infection or pyelonephritis, with common organisms including Escherichia coli and other enteric bacteria. Noninfectious causes include ureteral obstruction from stones or strictures, chemical irritation, irradiation, and post-procedural inflammation after catheterization or surgery. Obstruction can predispose to secondary infection and hydronephrosis.

Clinical features commonly involve flank or groin pain, dysuria, fever, nausea, and sometimes vomiting. Hematuria may be present, and urinary frequency or urgency can occur. Diagnosis is based on a combination of symptoms, urinalysis showing pyuria and bacteriuria, and urine culture to identify the organism. Imaging, such as ultrasound or CT urography, helps assess for hydronephrosis, stones, or strictures. Ureteroscopy may be used in uncertain cases or when obstruction or tissue diagnosis is needed.

Treatment focuses on the underlying cause. For infectious ureteritis, appropriate antibiotics and analgesia are used, with hydration and monitoring. If obstruction is present, relief with a ureteral stent or nephrostomy may be required. Noninfectious ureteritis is managed by addressing the underlying condition. Chronic ureteritis can lead to scarring and ureteral strictures, potentially impairing kidney function if not treated.