DEAR DR. DONOHUE: My wife is just getting over a kidney infection for which she was hospitalized. She has had similar infections in the past, and they were treated with antibiotics at home. What made this infection so different from her other ones? – P.J.

ANSWER: The urinary tract consists of kidneys, ureters (tubes that connect the kidneys to the bladder), the urinary bladder and the urethra (the tube that drains urine from the bladder to the outside world). An infection in any one of those structures is called a urinary tract infection.

Your wife’s previous urinary tract infections were most likely bladder infections. Bladder infections are quite common in women. They make a person uncomfortable and a frequent visitor to the bathroom, but they do not usually cause a raging fever and send a person to bed. They can be treated at home.

Your wife’s current urinary tract infection must be a kidney infection called pyelonephritis (PIE-el-low-nef-RIGHT-us). Kidney infections are more complicated, potentially more dangerous and make people much sicker than do bladder infections. With pyelonephritis, fever, chills and pain in the region of the involved kidney often require intravenous antibiotics in the hospital. Kidney infections, unless treated aggressively and promptly, can permanently damage the kidney and its ability to clear the blood of toxic byproducts.

Urinary tract infections are among mankind’s most frequent infections. The pamphlet on that topic gives a detailed discussion of all the types of urinary tract infections and their treatment. Readers can obtain a copy by writing to: Dr. Donohue – No. 1204, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.50 U.S./$6.50 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

DEAR DR. DONOHUE: For six straight months, I suffered from dizziness that made it impossible for me to get around or drive a car. I finally saw an ear doctor, who had me get an MRI scan. The scan showed that I had an acoustic neuroma. The doctor suggests that I have gamma knife surgery. I am not clear on the details of it. Is this ordinary surgery with a special knife? – G.P.

Acoustic neuromas are tumors of the insulating cells that wrap around and protect the hearing nerve. They are called benign tumors because they do not spread to distant body sites and they do not kill. “Benign,” however, is misleading. They are anything but benign in the symptoms they cause.

Acoustic neuromas can cause profound dizziness, loss of balance and hearing impairment.

The gamma knife procedure is not a surgical procedure. The gamma knife is a radiation procedure where high-energy radiation is directed to a very precise location. It attacks the neuroma like a fine knife. It does not scatter radiation beams to areas adjacent to the tumor. It is an effective treatment for acoustic neuromas, and you should have no reservations about having it.

Not all of these tumors can be treated with the gamma knife. There are other equally effective procedures for tumors that do not lend themselves to radiation treatment.

DEAR DR. DONOHUE: I had a dermoid cyst removed from an ovary. Before the operation the doctor thought that it might be ovary cancer. Naturally I am happy it was not. I cannot find much information on dermoid cysts. What are they? – K.R.

Dermoid cysts are nests of immature cells that contain skin, oil glands, hair follicles and teeth. The ovary is the usual site, but they can also be found in other places. In nearly 15 percent of ovarian dermoid cyst patients, dermoid cysts are found on both ovaries.

Some cysts are painful. Many are discovered by accident when a doctor feels a mass in the region of the ovary. Ultrasound pictures of the ovary demonstrate the cyst clearly.

You might not have been looking under the right heading for information on dermoid cysts. Try using their other name – benign cystic teratoma.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475.

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