Urethritis

　　Ureteritis often occurs secondary to pyelonephritis, cystitis, and other conditions, and can also be caused by hematogenous or lymphatic spread and the spread of infection from adjacent organs (such as appendicitis, ileitis, peritonitis, etc.); some patients may develop it due to medical device examinations, ureteral calculus friction, and medication. Acute ureteritis is mainly manifested as mucosal suppurative inflammation, while chronic ureteritis can manifest as ureteral wall dilation, thinning, and gradual elongation into a spiral shape, or it can also manifest as ureteral wall thickening, hardening, rigidity, fibrosis of the muscular layer, leading to complete ureteral stricture and hydronephrosis.

　　Ureteritis can cause upper urinary tract obstruction due to ureteral stricture, with common complications as follows:

　　1. Renal papillary necrosis

　　The renal papillary necrosis involves the entire pyramid, with large amounts of necrotic tissue sloughing off from the tip of the papilla to the junction of the renal cortex and medulla. Small pieces of tissue can be excreted in the urine, while large pieces can block the urinary tract. Therefore, when pyelonephritis is complicated with renal papillary necrosis, in addition to the aggravation of symptoms of pyelonephritis, renal colic, hematuria, high fever, and rapid deterioration of renal function can occur, and it can also lead to Gram-negative bacillary sepsis. If both kidneys are affected by acute renal papillary necrosis, the patient may experience oliguria or anuria, leading to acute renal failure. The diagnosis of this disease mainly relies on the etiology and clinical manifestations.

　　2. Perinephritis and perinephric abscess

　　The fat tissue between the renal capsule and the perirenal fascia that develops into an infectious inflammatory condition is called perinephritis. If it develops into an abscess, it is called perinephric abscess. This disease is mostly caused by the direct extension of pyelonephritis (90%), with a small part (10%) being caused by hematogenous infection. The onset of the disease is insidious, with significant clinical symptoms appearing after several weeks. In addition to the aggravation of symptoms of pyelonephritis, patients often experience unilateral significant lower back pain and tenderness, and some patients may feel a mass in the abdomen. When the inflammation involves the diaphragm, respiration and diaphragmatic movement are restricted, and there is often traction pain during breathing. X-ray chest fluoroscopy shows local diaphragmatic elevation. In cases caused by renal intramedullary lesions, there may be a large number of pus cells and pathogenic bacteria in the urine; in cases where the lesion is only in the perirenal area, there are only a small number of white blood cells. The diagnosis of this disease mainly relies on clinical manifestations, and X-ray examination, pyelography, ultrasound, and CT scans are helpful for diagnosis. Treatment should be started with antibiotics as soon as possible to promote the regression of inflammation, and if an abscess forms, it should be incised and drained.

　　3, Infectious renal calculi

　　Infectious renal calculi are formed by infection and are a special type of calculus, accounting for about 15% to 20% of renal calculi. Their main components are magnesium ammonium phosphate and calcium phosphate. The treatment of infectious renal calculi is difficult, with a high recurrence rate. If not properly handled, it may lead to chronic pyelonephritis and even renal failure.

　　4, Gram-negative bacillary sepsis

　　In Gram-negative bacillary sepsis, 55% are caused by urinary tract infections. The main manifestations are that most patients may have chills, high fever, and generalized sweating at the onset, and some patients may only have mild general discomfort and moderate fever. Later, the disease may become severe, and the patient's blood pressure may drop rapidly, even leading to obvious shock, accompanied by clinical manifestations of cardiac, cerebral, and renal ischemia, such as oliguria, azotemia, acidosis, and circulatory failure.

　　Ureteritis is mainly manifested as frequent urination, urgency, and dysuria, accompanied by lumbago and lumbar pain. In severe cases, hematuria, fever, and other symptoms may occur. When severe renal pelvis积水 occurs, there may be percussion pain in the renal area.

　　The following points should be done to prevent the onset of ureteritis:

　　One, stick to drinking plenty of water

　　The urine excreted by the kidneys has a flushing effect on the bladder and urethra, which is conducive to the excretion of bacteria. Drinking plenty of water every day and urinating every 2-3 hours can prevent the proliferation of bacteria in the urinary tract, reduce the incidence of urinary tract infections, and this is the most practical and effective method of preventing urinary tract infections. Drinking plenty of water every day during the onset or remission of the disease is also conducive to the recovery of the disease, and drinking tea or light bamboo leaf tea also has a certain preventive effect.

　　Two, pay attention to personal hygiene

　　The female genital area and urethral orifice are inhabited by a large number of bacteria, which are the prerequisite for the occurrence of urinary tract infections. Therefore, it is necessary to pay attention to the cleanliness of the genital area, take a bath frequently, and do not use pool or basin baths. Change underwear frequently, and pay special attention to this during marriage, menstruation, pregnancy, and puerperium. Newborn girls should also change diapers frequently.

　　Three, try to avoid using urinary tract infection instruments and catheters

　　Urological instruments are prone to carry bacteria from the distal urethra into the bladder and upper urinary tract, making it easy to develop persistent bacteriuria after urinary catheterization, thus, it should be avoided as much as possible. When necessary, strict disinfection should be carried out, and a urine culture should be performed 48 hours after the use of urological instruments to observe whether urinary tract infection occurs. For patients who already have bacteriuria before using urological instruments, it is advisable to control the infection first. Some patients may not have bacteriuria at the time, but have a history of recurrent urinary tract infections or urinary tract abnormalities. They should take antibiotics to prevent infection before and after urological examination or within 48 hours. For the first three days of indwelling urinary catheterization, the administration of antimicrobial drugs can prevent or delay the occurrence of urinary tract infection, but after 3 days, there is no preventive effect. In addition, a closed drainage system connected to the urinary catheter can significantly reduce the incidence of urinary tract infection.

　　Ureteritis is mainly identified through urinalysis, where leukocytes are visible, and urine culture shows the growth of pathogenic bacteria. When the bacterial count is greater than 10 to the power of 5, it indicates urinary system infection. Other examinations are mainly imaging examinations: if ureteritis causes spastic obstruction, an ultrasound can detect renal积水; IVU shows ureteral dilation or narrowing, ureteral rigidity, and irregular edges.

　　The following are the food therapy formulas suitable for ureteritis patients:

　　1. Chicken Intestine Formula

　　Chicken intestines 1 pair, 20 grams of Alisma orientale. Clean the chicken intestines, cook them with Alisma orientale together, remove the medicine residue, and drink it in the morning. Do not drink it at night.

　　2. Rice Cake

　　Rice noodles in appropriate amounts, made into rice cake, taken with warm wine. If the person cannot drink alcohol, take it with warm water. If taken at night, wait until the feeling of emptiness in the abdomen before going to sleep.

　　3. Propolis

　　It is a natural antibacterial substance that can be reused without side effects, rich in flavonoids, propolis has excellent antibacterial, anti-inflammatory, antioxidant blood purification, cell activation and regeneration, and elimination of free radicals in the body.

　　4. β-Carotene

　　It is an antioxidant that can effectively combat free radicals, help maintain the healthy operation of cells and tissues, enhance the body's immunity, maintain and promote the growth of epidermal tissues, and thus maintain the health of the respiratory tract, esophagus, urinary tract mucosa, and skin, preventing the occurrence of infection.

　　Ureteritis is divided into acute and chronic according to the degree of onset, and the symptoms and treatment are different.

　　1. Acute Ureteritis:The patient should rest in bed, drink plenty of water, alkalinize the urine, select appropriate antibiotics according to the pathogenic bacteria, and should continue until the body temperature returns to normal, systemic symptoms disappear, and the bacteria culture is negative for 2 weeks after the negative bacteria culture.

　　2. Chronic Ureteritis:Comprehensive measures should be taken for treatment. Including: general supportive therapy; strengthening antibiotic drug treatment, the use of antibacterial drugs should last at least 2-3 weeks, low-dose oral antibiotics need to be maintained for several months until repeated urine cultures are negative; thorough control and removal of infection foci in the body; surgical treatment to correct the primary lesions that cause infection.