Urethritis. Symptoms of urethritis and the main characteristic signs Urethritis causes symptoms treatment

Symptoms of inflammation of the urethra may resemble other diseases genitourinary system. But the treatment various pathologies significantly different from each other. Therefore, it is very important to correctly identify the existing disease (urethritis or something else). Laboratory and instrumental diagnosis of urethritis helps with this. Which methods are the most informative, how to prepare for them to obtain an accurate result, and how are they carried out? Let's talk about this in more detail.

How to detect urethritis using laboratory methods?

Help determine urethritis laboratory methods. They occupy the main place in the diagnosis of this pathology. The main methods that are used to identify urethritis are as follows:

Bacterioscopic - examination of the taken material under a microscope.
Bacteriological - inoculation of material on special media and study appearance grown colonies.
Serological - determination of antibodies (immunoglobulins of different classes) to the most common and probable pathogens of urethritis. Immunoglobulins can be systemic (class G and M) and local (class A, they are synthesized locally in the mucous membrane).
PCR diagnostics - detection in blood or other biological media (urine, urethral discharge, cervical canal) certain genetic sequences characteristic of a particular pathogen.
General clinical examination - urine and blood examination standard methods to assess the presence and extent inflammatory process. These tests are prescribed to almost every person who seeks medical help.

To establish the correct diagnosis of urethritis (if there are suspicious clinical signs or inflammatory changes in a general clinical urine test), it is necessary to first examine the discharge from the urethra. But some factors can distort the reliability of this analysis, so doctors adhere to certain rules when collecting material.

How to prepare for urethral analysis and how it is performed

The rules for obtaining discharge from the urethra differ for women and men.

For women, these rules include:

collection of material no earlier than 1 hour after urination;
use a sterile cotton swab. If there is no discharge, then a special endobrush (a brush like a small brush), which is turned clockwise several times, is inserted into the urethra to a depth of 2-4 cm.

For men, the collection rules are as follows:

2 hours or more must have passed since the last urination;
insert the endobrush into the urethra 2-4 cm and rotate 2-3 times clockwise.

In cases where urethritis occurs with unexpressed symptoms, and in chronic forms, taking the discharge using an endobrush is not always informative. Therefore, for such patients, doctors carefully scrape the mucous membrane using a Volkmann spoon. This procedure is well tolerated; minor discomfort may be felt during it.

The resulting material is either subjected to microscopy (bacterioscopic method) or sown on media (bacteriological method). Using a microscopic examination, it is possible to quickly and easily identify Trichomonas and gonococci (the method is less sensitive for other pathogens). But their absence in a smear does not mean that they are excluded as a cause of urethritis. In this case, if there is a suspicious clinical symptoms shown polymerase diagnostics. The detection of more than 5 leukocytes in one field of view in a smear is a reliable sign of an inflammatory process in the urethral zone, which is called urethritis.

Thus, using microscopy you can diagnose:

fact of urethritis (presence of inflammation);
its cause (a specific pathogen, especially if it is gonococcus or Trichomonas), which affects further tactics of patient management.

The advantage of bacteriological diagnosis of urethritis is the ability to determine the sensitivity of the causative microbes to antibiotics, so that the doctor can initially prescribe the one that will be most effective for a given patient.

Urine tests

Initially, if there are complaints of increased urination and pain, the doctor assumes urethritis, and therefore prescribes a general urine test. If it (or the Nechiporenko analysis) reveals large numbers of leukocytes or bacteria, a three-glass test is recommended.

A 3-glass test helps to conduct a topical diagnosis of damage to the urinary system, i.e. determine which organ is specifically inflamed.

It can also be used to evaluate:

number of pathogens in 1 ml of urine;
their appearance;
sensitivity to antibacterial drugs.

This test is especially informative if the cause of the disease is opportunistic microbes (if other methods do not detect them):

staphylococci;
streptococci;
Proteus;
E. coli, etc.

Using this analysis, it is possible to understand in which department urinary system inflammation developed. The results are interpreted as follows:

urethritis is when pathological changes detected in the first portion of urine;
prostatitis and cystitis lead to the appearance large quantity leukocytes in the second portion of urine;
pyelonephritis - inflammation of the kidneys - causes the appearance of leukocytes in all three samples.

Urethroscopy

In some cases, to clarify the nature of the mucosal lesion, the doctor may perform urethroscopy. This endoscopic method performed under anesthesia. Most often, modern highly effective local anesthetics are used; Previously, anesthesia was used for this, but because of it side effects This method of pain relief has now been abandoned.

A special thin probe with a video camera is inserted into the lumen of the urethra, and an image is displayed on the screen. Such diagnostics are carried out to establish the characteristics of damage to the urethra, as well as in the presence of prostatitis or inflammation of the seminal vesicles.

Urethroscopy can be performed on both men and women. There are 2 varieties of this method:

irrigation urethroscopy - to improve visualization of the urethra, in bladder saline solution is injected;
dry urethroscopy - instead of liquid, the doctor fills the bladder with gas as the urethroscope advances.

Depending on how the urethritis proceeds, the urologist chooses the most informative method of those considered. Besides inflammatory lesion urethra, using urethroscopy, the doctor can identify:

foreign bodies;
cysts;
tumor lesions;
dystrophic processes of the mucous membrane, often developing in women during menopause.

The method has virtually no contraindications. Only advanced urethritis limits its use, because due to the pronounced inflammatory process when inserting a urethroscope, there is a very high risk rupture of the urethra. In this case, diagnosis is based only on the results of laboratory tests.

For several days after urethroscopy, you may experience some discomfort associated with:

with the presence of sparse bloody discharge from the urethra;
with pain when going to the toilet “in a small way”.

If after the procedure the body temperature rises, the stream of urine weakens, or there is bleeding that does not stop, you should urgently go to a urologist. These symptoms may indicate possible complications urethroscopy, which is not lacking in any method of invasive (associated with the direct penetration of equipment into the human body) diagnostics, and urethroscopy is no exception.

Diagnosis of chlamydial urethritis

To identify chlamydial urethritis, the following methods can be used:

Bacterioscopic, in which the presence of chlamydia is determined in tissues (they are located intracellularly). The method for chlamydia is low-sensitive - only 10-20% of patients with chlamydial urethritis can detect this microorganism. Immunofluorescence increases the information content of the method. To do this, the drug is treated with antibodies and then exposed to fluorescent light. In the presence of chlamydia, a yellow-green glow is detected. This type of bacterioscopic method is quite informative. Thus, in approximately 70-75% of infected patients, the cause of urethritis can be determined.
Bacteriological method. It consists in the fact that the resulting material (discharge from the urethra) is introduced into a cell culture. Artificial nutrient media cannot be used for this, because Chlamydia does not grow on them. The method is highly sensitive - in 75-95% of people with chlamydial urethritis, causative microorganisms are identified. Due to the labor intensity in clinical practice it is not widespread. It is usually used to monitor complete healing. It will not be informative if it is carried out while taking antibiotics or within 1 month after the end of antibacterial therapy.
Serological methods. The titer of class G immunoglobulins to chlamydia is determined in the blood if there is a generalized form of infection or the material cannot be obtained, because organs are located in places difficult to reach for non-invasive diagnostics (for example, prostate, testicles, ovaries, etc.). But to identify urethritis, local immunity is studied - the titer of immunoglobulin A in the urethral canal is determined. However, the method has two drawbacks. It is not suitable for diagnosing acute chlamydial urethritis, because In response to infection, antibodies do not appear immediately, but after some time. The method cannot be used to assess whether the patient is cured or not, due to the fact that the immunoglobulin titer remains elevated for a long time. Serological methods are especially valuable for identifying sluggish and asymptomatic forms of urethritis, but when there is damage to the pelvic organs. In this case, the method is informative in 95% of cases of infection.
PCR diagnostics. The sensitivity of this method is almost 100%, i.e. it allows us to identify almost all patients infected with chlamydia. Various biological materials can be studied. But for men, they usually use the first portion of urine obtained immediately after waking up (there is no need to wash yourself, so as not to distort the results of the analysis), and for women, cervical mucus (if chlamydia is detected in it, then it is also in the urethra). The main advantage of PCR diagnostics is the simultaneous detection of several pathogens of urethritis in the same sample of biological material. Thus, in urine or cervical secretions, in addition to chlamydia, different types of mycoplasmas and ureaplasmas can be detected. However, there is one drawback. PCR cannot be used to confirm complete destruction of chlamydia in the body (cure of infection). This is due to the fact that PCR detects even non-viable fragments of DNA and RNA, which remain in the body for 2-3 months after the end of successful antibacterial therapy.

The diagnosis of gonorrheal urethritis in most cases is established based on the results of a microscopic examination of the discharge of the urethra. In this case, diplococci are found, which resemble a coffee bean consisting of 2 halves. They:

located intracellularly,
have different shapes and different colors,
the outside is covered with a capsule.

To detect these pathogens of urethritis, a bacteriological examination is also carried out. The taken material is sown on meat-peptone media, and then the growth pattern on them is studied.

Diagnosis of gardnerella urethritis

Gardnerella urethritis can be detected by bacterioscopic methods. The taken material is examined unstained and after Gram staining.

In the first case, the sign that indicates gardnerellosis is the presence of key cells. They are cells squamous epithelium, lining the urethra, to which gardnerella bacteria are attached.

In the second case (when the preparation is stained), this infection is indicated by:

individual leukocytes, randomly scattered in the fields of view;
a large number of bacteria that have a negative Gram stain, with a considerable part of them attached to epithelial cells.

Diagnosis of mycoplasma and ureaplasma urethritis

It is not easy to identify urethritis caused by mycoplasmas or ureaplasmas. Widespread microscopic diagnostic methods turn out to be uninformative due to the large species diversity of these bacteria.

Cultural methods are also not always informative, because even if there is growth by nutrient media- this does not mean infection. Mycoplasmas and ureaplasmas can be opportunistic inhabitants urinary tract men and women, without causing development inflammatory reaction.

Therefore, at present, urethritis, which is presumably associated with these microorganisms, is an indication for PCR diagnostics.

Diagnosis of herpetic urethritis

Urethritis caused by herpes viruses type 1 or 2 is diagnosed using one of the following methods:

microscopy of smears taken from local rashes and the urethra. At the same time, the laboratory assistant determines a large number of giant cells and intracellular inclusions;
PCR method to detect viral DNA;
immunofluorescence - a bright green glow is detected in smears.

Diagnosis of fungal urethritis

Fungal urethritis is easy to diagnose. During a microscopic examination of the smears taken, the laboratory technician sees a large number of micellar filaments located in thick mucus. There is no point in using more expensive methods to diagnose candidiasis, because... microscopy is highly informative.

Diagnosis of Trichomonas urethritis

Trichomonas urethritis does not present difficulties for diagnosis, because It has typical symptoms(more details in the section “Symptoms of urethritis”). However, the following methods help to finally determine the causative microorganism (Trichomonas):

bacterioscopy - even in an unstained preparation, a laboratory assistant can easily identify Trichomonas;
bacteriological examination, but it is less common because microscopy is quite informative.

Conclusion

The presence of symptoms of urethritis is an indication for laboratory and/or instrumental diagnostics. Its task is to confirm inflammation of the urethra, as well as to identify its cause (a specific microorganism). This helps the doctor carry out differentiated treatment and cure the patient’s urethritis.

Urethritis - inflammation of the urethra , a very common urological disease. As a rule, urethritis in men is more severe than urethritis in women. The cause of urethritis is most often the presence of a sexually transmitted infection in one of the partners.

Symptoms of urethritis

The insidiousness of the disease lies in the fact that the usual general inflammatory manifestations (fever, weakness, malaise) are most often not observed with urethritis. The disease urethritis can generally occur without pronounced symptoms. In this case, one of the partners may suffer the disease much more severely. Urethritis can make itself felt even after a considerable time after infection - from several hours to several months with nonspecific infectious urethritis.

The main symptoms of urethritis may be as follows:

pain and burning when urinating (in women they are localized mainly at the end of the urethra (outside), in men - along the entire length of the urethra);
abundant mucopurulent discharge from the urethra (mainly in the morning) with a sharp specific odor;
frequent urge (with an interval of 15-20 minutes) to urinate;
incomplete emptying Bladder;
urinary disorders;
cloudy urine, drops of blood may appear in it at the end of urination;
change in the external opening of the urethra in color and shape;
irritation of the glans penis and foreskin in men;
pain during erection in men;
high content leukocytes in a general urinalysis.

Types of urethritis

Depending on the degree of intensity of the process and the duration of the disease, there are acute urethritis And chronic urethritis .

For acute urethritis characterized by a bright onset and severity of all symptoms, the duration of the disease is up to 2 months.

Chronic urethritis (disease lasting more than 2 months) is characterized by the duration of the course, erased symptoms and the development of complications.

Based on the nature of occurrence, the following types of urethritis are distinguished:

primary (after sexual intercourse or therapeutic manipulations in the groin area) and secondary urethritis (the appearance of infection from other organs of the genitourinary system);
allergic urethritis (allergy to medications, shampoos, soaps, condoms);
chemical urethritis (reaction to entry into the urethra medicines);
mechanical urethritis (arises due to mechanical damage urethra);
infectious urethritis (caused by specific pathogens, such as chlamydia, mycoplasma, ureaplasma, gardnerella, gonococcus, and nonspecific pathogens (streptococcus, staphylococcus, E. coli);
non-infectious urethritis , occurs due to injuries to the urethra (due to the passage of a stone during urolithiasis, when using a bladder catheter), as well as due to narrowing of the urethra and congestion in the pelvis;
nonspecific urethritis - purulent inflammation, which is caused by streptococci, staphylococci and Escherichia coli;
specific infectious urethritis - appears as a result of a sexually transmitted infection.

According to pathological signs, the following types of urethritis can be distinguished:

gonorrheal urethritis (the causative agent of the disease is gonococcus, infection through sexual intercourse with an infected person, through underwear, general subjects hygiene and personal use - washcloths, towels, etc.);
bacterial urethritis (the causative agent is a nonspecific bacterial flora, the disease can appear as a result of endoscopic manipulations, long-term use catheter);
trichomonas urethritis (characterized by the presence of foamy, whitish discharge, itching, in the absence of treatment quickly turns into chronic form and trichomonas prostatitis);
candidal urethritis (the causative agent is a yeast fungus that affects the mucous surface of the urethra, appears after prolonged use antibacterial drugs, less often after contact with an infected partner);
chlamydial urethritis (viral urethritis, affects the urethra, conjunctiva, vagina and cervix).

Features of urethritis in men and women

Men (due to their anatomical structure- longer and narrower urethra) they feel the manifestations of urethritis earlier and more acutely, while a woman may not notice its symptoms at all. Men may experience redness and sticking of the sponges of the external opening of the urethra in the morning.

Urethritis in men

The cause of urethritis in representatives of the stronger sex can be the following factors:

infection through sexual intercourse;
hypothermia of the body;
presence of stress;
unbalanced diet with a lot of spicy, sour, salty foods;
inflammatory process in the body;
the presence of urolithiasis.

Chronic urethritis in men occurs rarely when the following conditions occur:

untreated acute urethritis;
expansion of the inflammatory process to the entire urethra and prostate gland;
weakening of the immune system.

Urethritis in women

Compared to urethritis in the stronger sex, female urethritis appears as a result of various infections. If the disease is not treated, then due to the female anatomical structure, urethritis can quickly develop into cystitis.

Main role play a role in the disease of urethritis in women various infections. Among the infectious types of urethritis in women, the most common is gonorrheal. Within 12 hours of infection, a woman may experience symptoms of acute urethritis. If left untreated, after 20 days the disease becomes chronic.

Quite often women become infected the following types urethritis: chlamydial , trichomonas or candida .

Candidal urethritis in women can occur with long-term use of antibacterial agents.

Typically, the first signs of the disease occur at the beginning of menstruation, the cessation of contraceptives, or the onset of menopause.

Diagnosis and treatment of urethritis

Treatment of urethritis requires careful diagnosis, you need to undergo special tests for urethritis. First of all, this is the collection and culture of secretions from the urethra (if they are absent, an analysis of the first portion of urine is collected). Laboratory diagnostics allows you to determine the causative agent of urethritis and its sensitivity to various groups of antibiotics. This allows you to make a correct diagnosis and prescribe adequate therapy.

An important diagnostic method is urethroscopy.

In addition, additional studies (ultrasound, MRI) may be required to exclude an inflammatory process in other organs (in women - in the bladder, in men - in the prostate gland and seminal vesicles).

Treatment of urethritis

The standard treatment program for urethritis consists of 3 stages:

establishing and clarifying the diagnosis;
drug therapy;
conducting a re-examination.

Drugs for the treatment of urethritis

The usual treatment program for urethritis includes the use of the following means for the treatment of urethritis:

antibiotics (for urethritis they vary depending on the type of disease);
medicines, restoring intestinal microflora;
anti-inflammatory drugs;
antihistamines;
immunostimulants;
vitamin complexes.

Self-medication in in this case can lead to serious complications. Only a urologist can select the correct medications for the treatment of urethritis based on the results of the examination.

The course of treatment can last from several days to several weeks and depends on the form of the disease. Treatment of urethritis is usually carried out on an outpatient basis, but severe purulent complications require hospitalization.

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Urethritis is an acute or chronic inflammation of the urethra (urethra) in both men and women. Urethritis is one of the common urological diseases resulting from both infectious and non-infectious causes.

Causes

Urethritis is:

infectious origin (microbial, viral, fungal),
non-infectious (allergic, traumatic, scarring, as a result of exposure to foreign bodies, as a result of irritation from sand or salts in the urine, stagnant, due to poor circulation in the pelvic area).

Usually, as a result of the influence of the primary factor, a secondary infection quickly attaches and the formation of a secondary infectious urethritis.

Infectious urethritis is divided into two large groups:

specific, caused by infections that are sexually transmitted (gonorrhea, gardnerellosis, trichomoniasis),
nonspecific, caused by intestinal or skin microflora (Escherichia coli, staphylococci, streptococci).

Specific urethritis most often occurs in young people, from 18 to 30-40 years old, as a result of sexual contact with a patient; nonspecific urethritis can develop at any age.

Urethritis can occur overtly or covertly, depending on the strength of the immune system and the characteristics of the pathogen. Predisposing factors are

hypothermia,
violation of intimate hygiene,
alcohol intake and the presence of foci of infection.

For nonspecific urethritis important factor there may be an exacerbation of urolithiasis with the detection of sand in the urine, a metabolic disorder with crystallization of urine, etc.

Symptoms of urethritis

Symptoms of urethritis in men and women can differ significantly due to anatomical features in the structure of the urethra.

In men, the urethra is long, thinner and more convoluted, in women it is short and wide, funnel-shaped. Men have much more pain receptors in the urethra than women, and are perceived painful sensations It's different for men. Urethritis in men usually occurs in isolation, as a separate disease, while in women, urethritis is often combined with cystitis.

Due to these features in men, the process usually begins acutely, with pronounced and acute manifestations, burning and unbearable pain and itching, while in women the manifestations can vary from gradual and not pronounced to quite strong, but increasing gradually. In some women, subjective symptoms of urethritis are completely absent in the presence of inflammatory phenomena in the urethra.

The main symptoms of urethritis include:

burning along the urethra,
pain when urinating,
pain inside the urethra, especially in its initial part at the head of the penis or labia,
discharge from the urethral canal in the morning is abundant, mucous or purulent in nature,
bad smell discharge.

In the morning, men may experience difficulty urinating due to the sticking of the sponges in the area of the head of the penis, and there is pronounced redness in the area of the exit from the urethral opening. As a variant of the course of urethritis, men may only have unpleasant sensations during urination, with a feeling of sand or broken glass along the urethra.

Typically, urethritis is limited to local manifestations; fever, malaise and weakness do not occur, which is why patients often practice self-medication without turning to specialists.

Diagnostics

Urologists diagnose and treat urethritis. It is necessary to conduct an examination and take smears from the urethra, general analysis urine and urine culture for flora, determining their sensitivity to antibiotics.

Additionally, an ultrasound examination of the bladder and kidneys, and in men also of the prostate, is prescribed to exclude the spread of infection to these organs.

Treatment of urethritis

The basis of treatment for urethritis in both men and women is antimicrobial therapy.

The antibiotic is selected taking into account the expected nature of the infection, with correction based on culture results - usually

sulfonamides,
norfloxacin,
tetracyclines,
erythromycin.

Often an antibiotic is prescribed with minimal possible reception, usually once or twice a day. The course of treatment is on average 5-10 days, depending on the severity of the disease. Treatment is carried out at home, under the supervision of a doctor.

In addition to the main treatment, they may be prescribed urological fees and uroantiseptics, chemical and plant origin, which have antimicrobial, anti-inflammatory and diuretic effects. Cranberry juice, bearberry leaf, kidney tea, uloresan and parsley infusion are useful.

It is necessary to drink enough fluids to maintain adequate diuresis and flush out tissue waste and germs or viruses.

It is important to follow a fairly restrictive diet, strictly exclude alcohol, reduce the consumption of salty, spicy and irritating foods to a minimum, take more plant and dairy foods that alkalize the urine - microbes survive less well in an alkaline environment.

During treatment, it is necessary to abstain from sexual activity, and if a sexually transmitted infection is detected, it is necessary to examine and treat the sexual partner. After the course of treatment, it is necessary to undergo follow-up tests to ensure that the infection is completely eliminated.

Complications

If urethritis is not treated, its manifestations gradually subside or become chronic course. The infection spreads deep into the genitourinary system and affects the prostate and seminal vesicles; in women, it spreads to the bladder and glands of the vaginal vestibule. When exposed to provoking factors, relapses of inflammation occur, and the infection can spread to the bladder, ureters and kidneys.

The main manifestations of urethritis are problems with urination and pain. It appears due to the fact that there is inflammation in the canal.

Both women and men can suffer from urethritis.

It occurs due to the fact that the urinary tract becomes infected with a fungus, bacteria or virus.

Duration incubation period can range from five to thirty days.

The most common reason - venereal diseases, which are transmitted during sexual intercourse, and failure to comply with the simplest rules of hygiene. Very often urethritis is the first symptom infectious disease. One of the reasons is the presence of chronic inflammatory diseases or impaired metabolic processes.

The walls of the urinary tract can also be irritated due to diet: alcohol, foods high in salt and spices. As a result, their inflammation begins.

The symptoms of urethritis are not acute; they appear some time after the infection has occurred. In addition, in half of the cases of acute urethritis there may be no symptoms, the patient does not have any complaints. But, despite this, sexual transmission of the infection is possible, and complications may arise.

In males, urethritis has a shorter incubation period, it has a more violent onset and more severe symptoms.

The main manifestations of urethritis are:

itching during urination;
difficulties with the outflow of urine;
pain in the pubic area;
discharge of pus from the urethra;
the appearance of blood in the urine.

Despite the inflammatory nature of the disease, general state the patient is not disturbed. Most often, patients consult a urologist, but all symptoms may not be present. Some of them may be very pronounced, and some may be completely absent.

It is worth noting

As the disease becomes chronic, symptoms may disappear. Their further occurrence may be periodic.

In female representatives, the length of the urethra is small, about a couple of centimeters, but it is quite wide. Due to the anatomical structure of the female urethra, pathogens easily penetrate the bladder. Even if the mucous membrane of the urethra swells slightly, the outflow of urine is disrupted.

It is important to know

Despite the absence of a threat to life, urethritis leads to unpleasant sensations, and complications are dangerous for women's health. Often women suffer from a parallel course of two diseases: urethritis and cystitis.

In this case, cystitis is the simplest complication that causes urethritis. Therefore, the disease must be treated in time, otherwise an ascending infection may develop, the complications of which are difficult to cope with.

During pregnancy, the development of the inflammatory process occurs faster, so urethritis symptoms are more pronounced. You should consult a doctor if you experience pain and itching during urination, the appearance of pus in the urine, or redness of the external genitalia.

Often the bladder can become inflamed after childbirth. When the fetus moves through the genital tract, compression and injury to the pelvic organs occurs. The damage may not be noticeable. In a nursing mother, the disease may occur due to bladder catheterization, which is performed after childbirth. Despite the fact that sterilized instruments are used during manipulation, the mucous membrane is damaged and bacteria enter through microscratches. Immediately after childbirth, a heating pad with ice is often placed on the stomach, which leads to hypothermia and decreased immunity.

Should be understood

For such reasons, cystitis cannot develop in a healthy woman, which means either hygiene is poor or there is a chronic infection.

Sometimes urethritis occurs in children, but less often than in adults. Making a diagnosis is usually quite difficult, since the manifestations are not particularly pronounced.

In boys, the disease is characterized by:

burning during urination;
the appearance of blood in the urine;
white or purulent mucous discharge;
itching and burning of the penis.

Girls are characterized by:

painful sensations in the abdomen and when urinating;
frequent urge to go to the toilet.

Forms and types of urethritis

There are many different types of urethritis, one of them is trichomonas. It is caused by Trichomonas, a pear-shaped pathogen that reproduces by longitudinal division. In the case of women, pathogenic microorganisms live in the vagina, and in the case of males, in the prostate gland and seminal vesicles. The most common inflammation of the urethra occurs. Sexual contact leads to primary infection.

In large quantities, vaginal Trichomonas lead to a moderate inflammatory reaction, and in 20-35% of cases, infected people are asymptomatic carriers. But, if there are symptoms of urethritis, they will appear in ten days. Sometimes there are cases of the incubation period being shortened to a couple of days or extended to two months. Men most often experience an acute form of trichomonas urethritis, and women most often experience an asymptomatic form.

IN initial stage The patient suffers from itching in the area of the urethra. Men experience a small amount of discharge from the urethra, which is gray or whitish in color. Sometimes a burning sensation is felt when urinating, which remains for some time.

If Trichomonas urethritis is not treated, remission will occur in about a month and all symptoms will completely disappear. However, this does not lead to the disappearance of the source of infection, and the disease becomes chronic over time.

An exacerbation may be sudden, the reason may be as simple as:

active sexual intercourse;
exposure to cold;
alcoholic drinks in large quantities.

Treatment of trichomonas urethritis in the initial stage will be easier. To do this, the body is completely examined by a doctor, and a scraping is also performed from the urethral mucosa. But obtaining reliable information is only possible with the help of a fresh smear.

Therapy can only be called effective if two partners undergo it, even if one of them has no symptoms.

Taking into account the form of the disease, the doctor prescribes medications and dosage. The duration of the course is no more than five to seven days. Very often they use not only local methods of treatment, but also use antibacterial and disinfectant drugs. Despite this, not all patients recover, so additional rinses may be prescribed.

It is quite common and chronic urethritis (gonococcal). It can be infected not only during sexual contact, but also through everyday contact. The duration of the incubation period is from three days, although in some cases the first symptoms of urethritis may appear after twelve hours.

The main symptoms of this type are the appearance of pus from the urethra, which has a pale yellow or yellowish-green color. If the disease occurs in acute form, discharge is abundant, swelling of the urethra, burning and pain when urinating are observed. In addition, the patient complains of a frequent urge to urinate, severe pain in the urethral area and increased temperature.

Treating chronic urethritis is quite long and laborious. First of all, the urethra is examined in detail and various tests are performed. After confirmation of the diagnosis, immunotherapy and antibacterial drugs are prescribed. When the body is exposed to Trichomonas and gonococcus, acute urethritis develops. It can also appear due to injury or chemical irritants.

The main symptoms of gonococcal urethritis:

pain and burning in the urethra;
frequent urge to go to the toilet;
urethra with inflammation and swelling;
purulent discharge.

In some cases, the external opening in the urethra swells. In this case, the canals are opened, since urinary retention may cause genitourinary fistulas or paraurethral abscesses.

It is worth noting

To treat acute urethritis, anti-inflammatory therapy is used, consisting of antibiotics, sulfonamides, warm baths, drinking and rest. In addition, if you have acute urethritis, you should avoid sexual intercourse.

Infectious urethritis caused by gardnerella, streptococcus, gonococcus, staphylococcus and E. coli.

In this form, urethritis manifests itself in the following symptoms:

pain and stinging when urinating;
morning discharge, which has an unpleasant odor and consists of mucus and pus, the color is blue-green;
in the case of men, the sponges of the external opening of the urethra may stick together and redness may appear on them;
In women there is no discharge, there is discomfort when urinating.

Most often, infectious urethritis is treated with antibacterial therapy. First of all, it is determined how sensitive the pathogen is to different types antibiotic. Then he is appointed required dosage and duration of admission. The course duration ranges from several days to several weeks. The patient should drink in significant quantities, exclude fried foods, foods with salt and spices from the diet.

As local treatment drugs are injected into the urethra. If the case is without complications, it is treated at home, but if severe purulent complications develop, hospitalization will be required.

When certain microorganisms enter the urethra, development occurs bacterial nonspecific urethritis. Most often it is caused by Escherichia coli, staphylococci, streptococci, and enterococci. They can often live on the lining of the urinary tract, but this will not always cause disease to develop.

There are a number of factors predisposing to the disease, which are presented:

injuries of the urethra;
cystoscopy;
bladder catheterization;
release of small stones;
congestion in the pelvic organs.

It is important to know

The primary cause of bacterial urethritis can be specific pathogenic microorganisms, due to which local protection is reduced and opportunistic flora is activated.

When treating bacterial urethritis, probable pathogens are taken into account and prescribed antibacterial therapy in combination with uroantiseptics. The pathogenic influence of yeast-like fungi of the genus Candida leads to the development of an infectious disease - candidal urethritis. The shape of these unicellular microorganisms is round. The cell consists of a membrane, protoplasm, nucleus and inclusions. The method of reproduction of yeast-like fungi is budding. They have the ability to elongate cells, which leads to the formation of pseudomycelium.

U candidal urethritis quite widespread, but most often women are infected with it. Quite often the process becomes chronic, while the symptoms of urethritis are not expressed. In addition, yeast-like fungi have the ability to quickly form drug-resistant forms.

The main method of transmission of candidal urethritis is sexual contact. The source of the disease is represented not only by patients, but also by candida carriers. Often the infection can be mixed.

Urethritis can often appear as a complication urolithiasis. With her in urinary tract stones appear, which cause the inflammatory process. As in the case of gout, with urolithiasis, the formation of salts of phosphoric, oxalic and uric acids occurs. Prolonged irritation of the urethral mucosa by them leads to inflammation. In addition, it is possible that sand and stones get into the urethra with urine, its walls are injured, which leads to urethritis.

It should be taken into account that the course of urethritis may be asymptomatic or they may be very mild, which is especially true for women. At the first sign discomfort in the process of urination, you should seek help from a specialist.

is a disease characterized by the manifestation of an inflammatory process in the urethra. The most striking signs of urethritis are severe pain during urination, as well as the appearance of discharge from the urethra. This disease is diagnosed in patients of both sexes.

Types of urethritis

Urethritis – infectious disease Therefore, its development occurs due to exposure to an infectious agent. These may be viruses , mushrooms , bacteria etc. Also in especially rare cases, diseases occur radial , toxic , allergic urethritis and some other types of it.

Depending on which pathogen causes urethritis to develop, there are two types: different types diseases: urethritis specific And nonspecific . In the first case, the occurrence of specific urethritis is provoked ( chlamydia , gonococcus , trichomonas , ureaplasma etc.) Such infections can be combined with the effects of other viruses, fungi, bacteria, and there may be several infections in the body. In this case, the disease is complicated by the fact that, as a rule, a person does not record when the acute stage of the disease turns into chronic.

Nonspecific urethritis occurs due to exposure to opportunistic microflora. Its occurrence is provoked staphylococci , streptococci , coli , fungi etc. The disease in both cases develops and manifests itself almost identically. But it is very important to take into account that if a sexually transmitted infection is detected, all sexual partners of the patient must undergo examination and treatment.

Features of urethritis

As a rule, the manifestation of specific urethritis occurs after sexual intercourse. However, it happens that a person becomes infected and becomes a carrier of the infection for a certain time. In this case, the disease can manifest itself at any time. Nonspecific urethritis may also occur as a result of sexual contact.

The cause of the development of the inflammatory process in the urethra is a failure of the immunity of the canal wall. The urethra is constantly infected, infection occurs through the blood, from the intestines, from the skin, and from other places. Particularly severe infection occurs during sexual intercourse. Therefore, as long as the wall of the urethra can cope with the infection, the disease will not develop. But at the slightest malfunction defense mechanisms an inflammatory process occurs, which is accompanied by all the accompanying symptoms.

There are a number of factors that often become predisposing during the onset of the disease. First of all, urethritis in men and women can occur as a result of one-time or constant hypothermia. The occurrence of urethritis is influenced by the presence of a person. When sand or stone moves along the urethra, it is quite possible that injuries to the walls and the subsequent occurrence of urethritis may occur. Penile injuries that are too severe predispose to the disease physical exercise, irregular sexual activity. However, too much sexual activity and frequent changes of partners can also trigger the development of the disease. It is not recommended to consume spicy foods too often, as well as over-salted, sour foods, pickled vegetables, and large amounts of alcohol. When substances from such foods enter the urine, they irritate the wall of the canal. As a result, inflammation may occur or progression of an existing disease may occur.

A provoking factor in the manifestation of urethritis is often insufficient drinking: irregular urination provokes the retention of bacteria in the body, because it is urine that washes them away from the wall of the bladder. With a several-hour break between urinations, the risk of developing inflammation increases markedly. Urethritis can also appear against the background chronic inflammation arising in the body.

Thus, there are quite a lot of factors that can subsequently become decisive in the development of urethritis. Therefore, this disease can occur in anyone.

Symptoms of urethritis

Already at the very beginning of the disease, they manifest themselves clearly severe symptoms urethritis: strong pain and pain, burning and itching sensations when urinating. Also, during the process of urination, a person may feel any other discomfort. Similar sensations occur in the genitals and perineum.

Another important symptom Urethritis is the appearance of discharge from the urethra. They can be of varied nature. So, depending on what pathogen provoked the urethritis, the discharge can be very abundant or very scanty. During an exacerbation of the disease, the edges of the external hole may become inflamed and stick together. However, in some cases, the development of urethritis is not accompanied by discharge at all.

With each subsequent exacerbation of the disease, inflammation affects an increasingly significant part of the mucous membrane of the urethra. Therefore, the symptoms of urethritis become more pronounced with each exacerbation. Therefore, if the disease is not treated with adequate methods, complications of urethritis may occur.

If we consider the symptoms of urethritis from the point of view of their manifestation in each type of disease, then some differences in the clinical picture are noticeable.

So, with acute urethritis in men and women, the main symptoms are strong burning sensation and pain during urination, the presence heavy discharge from the urethra, swelling and noticeable redness of the lips of the urethra. With torpid urethritis, subjective disorders are observed. They do not appear clearly, in some cases they are completely absent.

In the case of subacute urethritis, pain and swelling in the urethra decrease, and the amount of discharge also decreases. Only in morning time Sometimes a crust appears, gluing the external opening of the urethra. The urine is clear and may contain purulent threads.

For chronic urethritis, which manifests itself as a result of an incorrect approach to treatment or complete absence Thus, neurotic phenomena are possible. Most often, with this form of urethritis, small ones are present. They become more abundant subject to the presence of certain factors that provoke an exacerbation of the disease. This could be heavy drinking, agitation, or hypothermia. Symptoms of chronic urethritis are often similar to those torpid urethritis .

Total urethritis is characterized by inflammation of the urethra as a whole. The symptoms of this form of the disease are similar to those. It is important to take into account that in the absence of therapy, the symptoms of urethritis may disappear on their own. However, with each subsequent exacerbation of the disease, its symptoms will be even more pronounced. As a result, the patient may experience serious complications urethritis.

Diagnosis of urethritis

For proper treatment It is necessary, first of all, to correctly establish the diagnosis. First of all, the doctor tries to find out what reasons provoked the occurrence of urethritis in the patient. Thus, to identify the causative agent of the disease, different laboratory research(smear, DNA diagnostics, PCR). Often, the doctor prescribes an ultrasound examination of the pelvic organs to adequately assess their condition. Based on the results obtained, the patient is prescribed a specific therapy.

Treatment of urethritis

In order for the treatment of urethritis to be as effective as possible, it is necessary, first of all, to determine what infection provoked the inflammatory processes of the urethra. In the treatment of urethritis, the same treatment regimens are used as in the treatment , and a number of other diseases of the reproductive system. Various drugs are used to combat pathogenic microorganisms. First of all, this , as well as agents with antifungal and antiviral effects.

It is important that treatment of urethritis occurs in parallel in both sexual partners due to the high likelihood of transmission of infection during sexual intercourse.

Both specific and nonspecific urethritis are treated using the same principles. Such a classification is important from the point of view of the specific selection of drugs for the treatment of urethritis, as well as for understanding whether there is a need to treat the patient’s sexual partner.

If a patient is diagnosed with a combination of urethritis and cystitis, then an integrated approach to treatment is important. In this case, the doctor must prescribe the use of physiotherapeutic procedures, as well as instillation of medications into the bladder and urethra. The treatment process can last several days or several weeks: it depends on the severity of the disease.

The correct approach to treatment on the part of the patient is also important. Not only effective drug treatment, but also compliance with what is prescribed by the doctor , abstinence from alcohol, drinking plenty of fluids.

After the course of therapy is completed and all symptoms of the disease have disappeared, you should mandatory Carry out tests again to monitor the patient's condition. This will help ensure that the infection has been eradicated.

The doctors

Medicines

Prevention of urethritis

As measures to prevent urethritis, it is important to adhere to healthy eating by eliminating an abundance of spicy, salty, and sour foods from the diet, alcoholic drinks. Proper drinking regimen is also important: every day a person should drink sufficient quantity liquids. The best option– drinking plain still water. If necessary, you can use diuretics - this is suitable lime tea, cucumber, blackcurrant and cranberry juice, parsley.

You should also avoid hypothermia, wear warm and comfortable clothes in winter, avoid problems with stool, and carefully monitor genital hygiene. If you have symptoms of inflammation, you should immediately contact a specialist to treat the disease at an early stage.

Complications of urethritis

With absence necessary treatment Urethritis in men can be complicated by a number of phenomena. First of all, acute urethritis can become chronic. Possible development of inflammation prostate gland (prostatitis ), testicular inflammation ( orchitis ), inflammatory process of seminal vesicles ( vesiculitis ). Due to urethritis, it can also develop , balanoposthitis , possible narrowing of the urethra.

With urethritis in women, it is possible as a complication disturbance of vaginal microflora , Vinflammatory phenomena of the urinary tract .

List of sources

Urology: national leadership/ ed. ON THE. Lopatkina. - M.:GEOTAR-Media, 2009;
Kozlyuk V.A., Kozlyuk A.S. Urethritis in men. Current issues in diagnostics. Cytomorphology. Treatment. - Kyiv: Style-Premier, 2006;
Skriprin Yu.K., Sharapova G.Ya. Sexually transmitted diseases. - M.: Medicine, 2005;
Molochkov V.A. Sexually transmitted infections. Clinic, diagnosis, treatment / V.A. Molochkov, O.L. Ivanov, V.V. Chebotarev. M.: Medicine, 2006.