Ureteritis

Definition:
Ureteritis is inflammation of the ureter, the narrow tube that carries urine from the kidney to the bladder. It is relatively rare and often occurs secondary to other conditions, such as urinary tract infections (UTIs), stones, or radiation.

🔍 Causes of Ureteritis

1. Infectious (most common)

Usually part of an ascending urinary tract infection involving the bladder (cystitis) or kidney (pyelonephritis).
Bacteria like E. coli, Proteus, or Klebsiella can spread to the ureter.

2. Non-Infectious

Ureteral stones (urolithiasis) causing irritation and inflammation.
Radiation therapy (e.g. for pelvic cancers) → radiation ureteritis.
Tuberculosis – genitourinary TB can cause chronic ureteritis and strictures.
Autoimmune diseases – rare, may mimic infection.
Chemical irritation from catheterization or contrast agents during imaging.

⚠️ Symptoms

Often overlap with general urinary tract symptoms:

Flank pain or lower abdominal pain
Burning sensation during urination (dysuria)
Increased urinary frequency and urgency
Hematuria (blood in urine)
Fever or chills (if associated infection is present)
Nausea or vomiting (in severe cases)

🧪 Diagnosis

Urinalysis: Presence of white blood cells, bacteria, or blood.
Urine culture: Identifies causative bacteria.
Imaging:
- CT urogram or ultrasound to rule out stones or abscesses.
- Cystoscopy if lower urinary tract involvement is suspected.
Ureteroscopy (in selected cases): Direct visualization of inflammation.

🩺 Treatment

If infectious:

Antibiotics based on urine culture (e.g., ciprofloxacin, nitrofurantoin, or trimethoprim-sulfamethoxazole).
Pain control (NSAIDs, antispasmodics).

If non-infectious:

Treat underlying cause (e.g., remove stones, stop radiation if feasible).
Anti-inflammatory medications.
Stent placement in severe obstruction or stricture cases.

🚨 Complications if Untreated

Spread of infection to kidneys (pyelonephritis)
Formation of ureteral strictures or obstruction
Hydronephrosis
Chronic pain or recurrent infections