Help! I have a depression in my ureter

Dr Flo,
I am a 58-year-old man and the doctors found a depression/pocket in the left ureter. I think some urine usually collects in that pocket, allowing bacteria to multiply. I always feel itchy on the left thigh near my private parts. Is there a way this depression/pocket can be removed or treated. What can be done so that the ureter can be smooth? The issue has affected my sex life. My partner’s private parts also get itchy every time we have sex.
Charles

Dear Charles,
The tube that carries urine from the kidney to the bladder is called a ureter. It may have a pouch/pocket as a result of an abnormality during its formation before birth (ureterocele) or it could have an out-pouching called a diverticulum. Both of these make it easier for urine to collect in the pouch/pocket and it gets infected. Symptoms of a urine infection include frequently passing urine, pain when passing urine urethral itching or burning sensation, back or side or low abdominal pain and fever. In most cases, however, the ureterocele has no symptoms. Because you are over 50 years old, it would be advisable to do a prostrate check, in addition to urine tests and ultrasound scans. Surgery can be done to correct these pouches.
Any time you have an infection, your spouse should also be treated at the same time as you. The vaginal itchiness may be from recurrent infection (fungal, bacterial or viral) or it may be due to hormonal changes, or drying and thinning of the vaginal lining that occurs in women at menopause, if she’s at that age. It is advisable to have a high vaginal swab taken for analysis and culture. She would also benefit from blood sugar, urine and pap smear checks, plus other tests as necessary. Infections can be treated accordingly, and use of a personal lubricant can help reduce friction and irritation during intercourse. In case she is menopausal, there are steroid vaginal creams that can help reduce the itchiness.

Dr Flo,
Dyslexia, autism and epilepsy affect the nervous system. Please explain this.
Ali

Dear Ali,
Dyslexia is a learning disorder that affects the area of the brain that processes language. Someone with dyslexia has normal intelligence, but has difficulty with speech sounds and how they relate to words, leading to difficulty with reading. It is can be present throughout someone’s lifetime, but it is easiest to diagnose in children. Dyslexic children may have delay in speech, have trouble learning and remembering words, and may have difficulty understanding what they hear, especially if it said fast, and mixing words. They have difficulty getting the right word to give an answer, and difficulty reading. With assistance, these children can succeed academically, and as they grow, the symptoms may be less apparent.
Autism is a developmental disorder where there are problems with social skills, communication and there is repetitive and fixated behaviour. The symptoms may range from mild to very severe, and they are usually noticed by the time the child is between two and three years old. It cannot be cured but can be managed, especially if help is sought early.
Epilepsy is a problem of the brain where there is abnormal nerve signals/brain activity leading to seizures (uncontrollable muscle movements or loss of muscle control) or abnormal sensations, behaviour, and sometimes loss of awareness. It can happen due to genetics, or as a result of head trauma, brain infections, stroke, brain tumour, liver or kidney failure, or damage to the baby’s brain during pregnancy or at birth. It can be managed using medication and avoiding triggers.

Dr Flo,
My partner experiences a sharp and unbearable pain in various body parts including lower back, abdomen, hands and thighs. She has been feeling this way for one year now. The blood, urine and stool tests did not find anything. What can we do?
Will

Dear Will,
Your partner has had pain for a prolonged period of time and has pain in multiple body parts, suggesting she may be suffering from fibromyalgia. This is a nerve disorder where there is pain in several body parts (in four or five areas) accompanied by fatigue, memory problems and sleep and mood disorders, and difficulty concentrating. This diagnosis is made after checking for other disorders and not finding a cause for the pain.
It is advisable for her to be seen by a specialist physician or a rheumatologist. Some tests that may be done include a complete blood count, thyroid hormone levels, calcium and vitamin D levels, and checking for auto-immune disease (diseases where the immune system attacks healthy body tissues) and other tests as recommended. If any abnormalities are noted, then they will be managed accordingly.
There is no known cause of fibromyalgia, and it cannot be completely cured but it can be managed by taking painkillers, anti-depressants and some epilepsy medication,  which help in managing nerve pain. She would also benefit from physical and occupational therapy, counselling, stress management, exercise, having a good sleep routine, having a healthy diet and practising moderation with physical activity – do not do too much when feeling well, and do not do too little when feeling unwell.

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