Urethritis. Urethritis symptoms and main characteristic signs Urethritis causes symptoms treatment

Symptoms of inflammation of the urethra can resemble other diseases of the genitourinary system. But the treatment of various pathologies is significantly different from each other. Therefore, it is very important to correctly determine the existing disease (this is urethritis or something else). This is helped by laboratory and instrumental diagnostics of urethritis. What 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 identify urethritis by laboratory methods?

Laboratory methods help determine urethritis. 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 material taken under a microscope.
Bacteriological - sowing the material on special media and studying the appearance of the grown colonies.
Serological - determination of antibodies (immunoglobulins of different classes) to the most common and probable causative agents 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) of certain genetic sequences characteristic of a particular pathogen.
General clinical - a study of urine and blood using standard methods to assess the presence and degree of the inflammatory process. These tests are prescribed for almost every person who seeks medical help.

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

How to prepare for a urethral test and how is it done

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

In 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 endobrash (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:

after the last urination, 2 hours or more should pass;
endobrash is introduced into the urethra by 2-4 cm and rotated 2-3 times clockwise.

In those cases when urethritis proceeds with unexpressed symptoms, and in chronic forms, taking the discharge with the help of an endobrass is not always informative. Therefore, for such patients, doctors perform a careful scraping of the mucous membrane using a Volkmann spoon. This procedure is well tolerated; slight discomfort may be felt during it.

The resulting material is either subjected to microscopy (bacterioscopic method), or sown on media (bacteriological method). With the help of microscopic examination, it is possible to quickly and easily identify Trichomonas and gonococci (in relation to other pathogens, the method is less sensitive). But their absence in the smear does not mean that they are excluded as the cause of urethritis. In this case, in the presence of suspicious clinical symptoms, polymerase diagnostics are indicated. 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:

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

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

Urine tests

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

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

It can also help you evaluate:

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

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

staphylococci;
streptococci;
Proteus;
colibacillus, etc.

With the help of this analysis, it is possible to understand in which part of the urinary system inflammation has developed. The results are interpreted as follows:

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

Ureteroscopy

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

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

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

Irrigation urethroscopy - to improve the visualization of the urethra, saline is injected into the bladder;
dry urethroscopy - instead of liquid, the doctor fills the bladder with gas as the urethroscope moves.

Depending on how the urethritis proceeds, the urologist chooses the most informative method from those considered. In addition to inflammatory lesions of the urethra, with the help of ureteroscopy, the doctor can reveal:

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

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

For several days after the urethroscopy, some discomfort may be noted associated with:

with the presence of abundant bloody discharge from the urethra;
with soreness when going to the toilet "in a small way."

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

Diagnostics of the chlamydial urethritis

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

Bacterioscopic, in which the presence of chlamydia is determined in the tissues (they are located intracellularly). The method for chlamydia is low-sensitivity - only in 10-20% of patients with chlamydial urethritis it is possible to identify this microorganism. The information content of the method is increased by immunofluorescence. To do this, the drug is treated with antibodies, and then translucent in fluorescent light. In the presence of chlamydia, a yellow-green glow is detected. This type of bacterioscopic method is quite informative. So, in about 70-75% of infected patients, it is possible to establish the cause of urethritis.
Bacteriological method. It consists in the fact that the obtained material (separated from the urethra) is introduced into the cell culture. It is impossible to use artificial nutrient media for this, because chlamydia does not grow on them. The method is highly sensitive - causative microorganisms are identified in 75-95% of people with chlamydial urethritis. Due to its laboriousness in clinical practice, it is not widely distributed. It is usually used to monitor complete cure. It will turn out to be uninformative if it is carried out while taking antibiotics or within 1 month after the end of antibiotic therapy.
Serological methods. In the blood, the titer of class G immunoglobulins to chlamydia is determined, if there is a generalized form of infection or the material cannot be obtained, because organs are located in hard-to-reach places for non-invasive diagnostics (for example, prostate, testicles, ovaries, etc.). But to detect urethritis, a study of local immunity is carried out - the titer of immunoglobulins A in the urethral canal is determined. However, the method has two disadvantages. It is not suitable for the diagnosis of acute chlamydial urethritis. in response to infection, antibodies do not appear immediately, but after some time. The method cannot be used to assess whether a patient is cured or not, due to the fact that the titer of immunoglobulins remains elevated for a long time. Serological methods are especially valuable for detecting indolent and asymptomatic forms of urethritis, but when there is a lesion of 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 to identify almost all patients infected with chlamydia. Various biological material can be examined. But in men, they usually use the first portion of urine received immediately after waking up (you do not need to wash away, so as not to distort the results of the analysis), and in women, cervical mucus (if chlamydia is detected in it, then they are in the urethra). The main advantage of PCR diagnostics is the simultaneous detection of several causative agents of urethritis in the same sample of biological material. So, in the urine or cervical secretions, in addition to chlamydia, different types of mycoplasmas and ureaplasmas can be detected. However, there is also one drawback. PCR cannot be used to confirm the complete destruction of chlamydia in the body (cure for infection). This is due to the fact that even non-viable DNA and RNA fragments are detected using PCR, which remain in the body for 2-3 months after the end of successful antibiotic therapy.

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

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

To detect these causative agents of urethritis, a bacteriological examination is also carried out. The material taken is sown on mesopatamia media, and then the nature of growth on them is studied.

Diagnostics of the gardnerella urethritis

Gardnerella urethritis helps to detect bacterioscopic methods. The taken material is examined unstained and after Gram staining.

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

In the second case (when staining the drug), this infection is indicated by:

individual leukocytes, chaotically scattered in the fields of vision;
a large number of bacteria that have a negative Gram stain, while a large part of them are attached to epithelial cells.

Diagnostics of the mycoplasma and ureaplasma urethritis

Identifying urethritis caused by mycoplasmas or ureaplasmas is not easy. The widespread methods of microscopic diagnostics 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 on nutrient media, this does not mean infection. Mycoplasmas and ureaplasmas can be conditionally pathogenic inhabitants of the urinary tract of men and women, without causing the development of an inflammatory reaction.

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

Diagnostics of the herpetic urethritis

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

microscopy of smears taken from local lesions and urethra. In this case, the laboratory assistant determines a large number of giant cells and intracellular inclusions;
PCR method for detecting virus 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 taken smears, the laboratory assistant sees a large number of micellar filaments located in thick mucus. There is no point in using more expensive methods for diagnosing candidiasis, because microscopy is highly informative.

Diagnosis of Trichomonas urethritis

Trichomonas urethritis is not difficult to diagnose, because 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 detect 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 the inflammation of the urethra, as well as to identify its cause (a specific microorganism). This helps the doctor to provide differentiated treatment and to cure the patient's urethritis.

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

Urethritis symptoms

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

The main symptoms of urethritis can be as follows:

stinging and burning during urination (in women, they are localized mainly in the area of the end of the urethra (outside), in men - along the entire length of the urethra);
copious mucopurulent discharge from the urethra (mainly in the morning) with a pungent specific odor;
frequent urge (with an interval of 15-20 minutes) to urinate;
incomplete emptying of the bladder;
urinary disorders;
cloudy urine, it is possible that drops of blood 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;
soreness with erection in men;
high content of leukocytes in the general analysis of urine.

Types of urethritis

Depending on the degree of intensity of the process and the time 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 more than 2 months) is characterized by the duration of the course, erased symptoms and the development of complications.

By the nature of the occurrence, the following types of urethritis are distinguished:

primary (after sexual intercourse or treatment in the groin area) and secondary urethritis (the appearance of infection from other organs of the genitourinary system);
allergic urethritis (allergy to medicines, shampoos, soaps, condoms);
chemical urethritis (reaction to drugs entering the urethra);
mechanical urethritis (occurs due to mechanical damage to the 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 of the urethra (due to the passage of a stone with urolithiasis, when using a bladder catheter), as well as due to narrowing of the urethra and congestion in the small 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.

By 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 hygiene items 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 of a catheter);
trichomonas urethritis (characterized by the presence of foamy, whitish discharge, itching, if untreated, it quickly turns into a chronic form and into Trichomonas prostatitis);
candidal urethritis (the causative agent is a yeast fungus that affects the mucous surface of the urethra, appears after prolonged use of antibacterial drugs, less often after contact with an infected partner);
chlamydial urethritis (viral urethritis, affects the urethra, conjunctiva, vagina and cervix).

Features of the course of urethritis in men and women

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

Urethritis in men

The following factors can cause urethritis in the stronger sex:

infection through sexual intercourse;
hypothermia of the body;
the 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 rarely occurs when the following conditions appear:

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

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.

Various infections play the main role in the disease of urethritis in women. Among the infectious types of urethritis in women, gonorrheal is most often found. A woman may develop symptoms of acute urethritis 12 hours after infection. If it is not treated, then after 20 days the disease becomes chronic.

Quite often, women become infected with the following types of urethritis: chlamydial , trichomonas or candidal .

Candidal urethritis in women can appear with prolonged use of antibacterial agents.

Usually, the first signs of the disease occur at the onset of menstruation, withdrawal of contraceptives or the onset of menopause.

Diagnosis and treatment of urethritis

Treatment of urethritis requires careful diagnosis, you need to pass special tests for urethritis. First of all, this is the collection and sowing of discharge from the urethra (if they are absent, the 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 the correct diagnosis and prescribe adequate therapy.

Ureteroscopy is an important diagnostic method.

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

Urethritis treatment

The standard urethritis treatment program consists of 3 stages:

statement and clarification of the diagnosis;
drug therapy;
re-examination.

Drugs for the treatment of urethritis

A common urethritis treatment program includes the following treatments for urethritis:

antibiotics (with urethritis, they differ, depending on the type of disease);
medicines that restore the intestinal microflora;
anti-inflammatory drugs;
antihistamines;
immunostimulants;
vitamin complexes.

Self-medication in this case can lead to serious complications. Means for the treatment of urethritis can be correctly selected only by a urologist 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 carried out, as a rule, 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 most common urological diseases resulting from both infectious and non-infectious causes.

Causes

Urethritis are:

infectious origin (microbial, viral, fungal),
non-infectious (allergic, traumatic, cicatricial, as a result of the ingress of foreign bodies, as a result of irritation from sand or salts in the urine, stagnant, due to circulatory disorders in the pelvic region).

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

Infectious urethritis is divided into two large groups:

specific, caused by sexually transmitted infections (gonorrhea, gardnerellosis, trichomoniasis),
nonspecific, caused by the 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 intercourse with a patient, nonspecific urethritis can develop at any age.

Urethritis can occur explicitly and latently, depending on the strength of the immune system and the characteristics of the pathogen. The contributing factors are

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

For nonspecific urethritis, an important factor may be exacerbation of urolithiasis with the identification of sand in the urine, metabolic disorders with crystallization of urine, etc.

Urethritis symptoms

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

In men, the urethra is long, thinner and convoluted; in women, it is short and wide, and has the shape of a funnel. Pain receptors in men in the urethra are much more numerous than in women, and pain is perceived differently in 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 sharply, with pronounced and acute manifestations, burning and intolerable pain and itching, while in women, manifestations can vary from gradual and not pronounced, to quite strong, but growing gradually. In some women, the subjective symptoms of urethritis are generally absent in the presence of inflammation in the urethra.

The main symptoms of urethritis include:

burning sensation 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, abundant, mucous or purulent,
unpleasant odor of discharge.

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

Usually, urethritis is limited to local manifestations, there is no fever, malaise and weakness, which is why patients often practice self-medication without consulting a specialist.

Diagnostics

Urologists are engaged in the diagnosis and treatment of urethritis. It is necessary to conduct an examination and collection of smears from the urethra, conduct a general analysis of urine and urine culture for flora, with the determination of their sensitivity to antibiotics.

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

Urethritis treatment

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

The antibiotic is selected taking into account the alleged nature of the infection, with correction based on the results of cultures - usually this

sulfonamides,
norfloxacin,
tetracyclines,
erythromycin.

Often the antibiotic is given as little as possible, 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, urological fees and uroantiseptics, chemical and plant substances with antimicrobial, anti-inflammatory and diuretic effects, can be prescribed. Useful cranberry juice, bearberry leaf, kidney tea, uloresan and parsley infusion.

Drink enough fluids to maintain adequate urine output and flush out tissue debris and germs or viruses.

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

At the time of treatment, it is necessary to refrain from sexual activity, and if a sexual infection is detected, it is necessary to examine and treat the sexual partner. After the course of treatment, it is necessary to pass control tests to make sure that the infection is completely eliminated.

Complications

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

The main manifestations of urethritis are urinary problems and pain. It appears due to the inflammation in the canal.

Both women and men can get urethritis.

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

The incubation period can range from five to thirty days.

The most common reason is sexually transmitted diseases, which are transmitted during intercourse, and non-observance of the simplest rules of hygiene. Very often, urethritis is the first symptom of an 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 become irritated due to food: alcohol, foods high in salt and spices. As a result, their inflammation begins.

Disease urethritis symptoms are not acute, they appear after a time after the infection has occurred. In addition, in half of the cases of acute urethritis, there may be no symptoms, the patient has no complaints. But, despite this, sexual transmission is possible, in addition, complications may appear.

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

The main manifestations of urethritis are:

itching while urinating;
difficulties with urine outflow;
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, the general condition of the patient is not disturbed. Most often, patients visit a urologist, but all symptoms may not be present. Some of them may be strongly pronounced, and some may be completely absent.

Its useful to note

As the disease approaches a chronic form, 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 can easily penetrate into the bladder. Even if the mucous membrane of the urethra slightly swells, the outflow of urine is impaired.

It's important to know

Despite the absence of a threat to life, urethritis leads to unpleasant sensations, moreover, complications are dangerous for women's health. Often, women suffer from the 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 on time, otherwise the development of an ascending infection is possible, the complications of which are difficult to cope with.

During pregnancy, the development of the inflammatory process occurs faster, so the symptoms of urethritis are more pronounced. The doctor should be consulted if you experience pain and itching during urination, the appearance of pus in the urine, redness of the external genital organs.

Often, the bladder can become inflamed after childbirth. When the fetus moves along the genital tract, compression and injury to the pelvic organs occurs. The damage can be subtle. 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 the manipulation, the mucous membrane is damaged, and bacteria enter through micro-scratches. Immediately after childbirth, a hot water bottle with ice is often placed on the stomach, which leads to hypothermia and a decrease in immunity.

Should be understood

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

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

In boys, the disease is characterized by:

burning sensation 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 use 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 multiplies by longitudinal division. In the case of women, pathogenic microorganisms live in the vagina, and with males, in the prostate gland and seminal vesicles. The most common inflammation of the urethra. Sexual contact leads to primary infection.

In large numbers, vaginal Trichomonas leads to a moderate inflammatory reaction, and in 20-35% of cases, the infected are asymptomatic carriers. But, if there are symptoms of urethritis, then they will appear in ten days. Sometimes there are cases of shortening the incubation period to a couple of days or lengthening to two months. Men most often face the acute form of Trichomonas urethritis, and women with asymptomatic.

In the initial stage, the patient suffers from itching in the area of the urethra. In men, there is a little gray or whitish discharge from the urethra. Sometimes there is a burning sensation when urinating, which remains for a while.

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

An exacerbation may be sudden, the reason may be the simplest:

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

It will be easier to treat Trichomonas urethritis in the initial stage. For this, the body is fully examined by a doctor, and scraping from the urethral mucosa is also performed. But getting reliable information is only possible with a fresh brushstroke.

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

Given the form of the course of the disease, the doctor prescribes medications and dosages. 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 disinfectants. Despite this, not all patients recover, therefore additional washings may be prescribed.

It is quite common and chronic urethritis (gonococcal)... They can be infected not only during sexual intercourse, but also through everyday life. The incubation period lasts from three days, although in some cases the first symptoms of urethritis may appear even 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 an acute form, the discharge is abundant, there is edema of the urethra, burning sensation and pain during urination. In addition, the patient complains of frequent urge to urinate, severe pain in the urethra and fever.

To treat chronic urethritis is long enough and laborious. First of all, the urethra is examined in detail, various tests are performed. After confirming the diagnosis, immunotherapy and antibacterial drugs are prescribed. When the body is affected by Trichomonas and gonococcus, acute urethritis develops. It can also appear due to trauma or chemical irritants.

The main symptoms of gonococcal urethritis:

pain and burning sensation in the urethra;
frequent urge to use the toilet;
urethra with inflammation and edema;
purulent discharge.

In some cases, the external opening in the urethra swells. In this case, the opening of the canals is performed, since urinary fistulas or paraurethral abscesses may occur due to urinary retention.

Its useful to note

For the treatment of acute urethritis, anti-inflammatory therapy is used, consisting of antibiotics, sulfonamides, warm baths, drinking and rest. In addition, in the presence of acute urethritis, sexual intercourse should be avoided.

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

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

pain and cramps 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, redness appears on them;
women have no discharge, there is discomfort when urinating.

Most often, with infectious urethritis, antibiotic therapy is performed. First of all, it is determined how sensitive the pathogen is to different types of antibiotics. Then the required dosage and duration of administration is prescribed. The duration of the course ranges from several days to several weeks. The patient should drink a lot, exclude fried foods, foods with salt and spices from the diet.

As a topical treatment, medications are injected into the urethra. If the case is without complications, he is treated at home, but if severe purulent complications have developed, 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, enterococci. They can often live on the mucous membrane of the urinary tract, but this does not always lead to the development of the disease.

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

trauma to the urethra;
cystoscopy;
bladder catheterization;
the allocation of small stones;
congestion in the pelvic organs.

It's important to know

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

In the treatment of bacterial urethritis, probable pathogens are taken into account and antibiotic therapy is prescribed in combination with uroantiseptics. The pathogenic effect 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 way of reproduction of yeast-like fungi is budding. They have the ability to elongate cells, which leads to the formation of pseudomycelium.

Have candidal urethritis quite widespread, but most often women are infected with it. Quite often, the process becomes chronic, while the symptoms of urethritis are mild. In addition, yeast-like fungi have the ability to rapidly form drug-resistant forms.

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

Often, urethritis can appear as a complication of urolithiasis. With her, stones appear in the urinary tract, which become the cause of 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 mucous membrane of the urethra by them leads to its inflammation. In addition, it is possible for sand and stones to enter 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 of discomfort during urination, you should seek the help of 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 is an infectious disease, therefore, its development occurs as a result of exposure to an infectious agent. These may be viruses , mushrooms , bacteria and others. Also, in especially rare cases, there are diseases beam , toxic , allergic urethritis and some of its other types.

Depending on the effect of which pathogen develops urethritis, two different types of disease are distinguished: urethritis specific and non-specific ... In the first case, the occurrence of specific urethritis is provoked ( chlamydia , gonococcus , trichomonas , ureaplasma and others) Such infections can be combined with the effects of other viruses, fungi, bacteria, while 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 a chronic one.

Nonspecific urethritis is manifested as a result of exposure to opportunistic microflora. Its occurrence is provoked staphylococci , streptococci , Escherichia coli , fungi and others. The disease in both cases develops and manifests itself in almost the same way. But it is very important to take into account that if a sexual infection is detected, all sexual partners of the patient must be examined and treated.

Features of urethritis

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

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, from other places. Especially strong infection occurs during sexual intercourse. Therefore, as long as the wall of the urethra can cope with the infection, the disease does not develop. But at the slightest malfunction of the defense mechanisms, an inflammatory process occurs, which is accompanied by all the accompanying symptoms.

There are a number of factors that often become predisposing to the onset of the disease. First of all, urethritis in men and women can occur as a result of a single or constant hypothermia. The occurrence of urethritis is influenced by the presence in a person. When sand or a stone moves along the urethra, it is quite possible for the occurrence of wall injuries and the subsequent occurrence of urethritis. Penile injuries, too heavy physical activity, irregularity of sexual activity predispose to the disease. However, too high sexual activity and frequent change of partners can also provoke the development of the disease. Too frequent consumption of spicy foods, as well as salty, sour foods, pickled vegetables, and a large amount of alcohol is not recommended. Once in the urine, substances from such food irritate the canal wall. As a result, inflammation may occur or the progression of an existing ailment may appear.

Insufficient drinking often becomes a provoking factor in the manifestation of urethritis: irregular urination provokes a retention of bacteria in the body, because it is urine that washes them from the wall of the bladder. With a break of several hours between urination, the risk of developing inflammation increases markedly. Also, urethritis can manifest itself against the background of chronic inflammation that occurs in the body.

Thus, there are many factors that can subsequently become decisive in the development of urethritis. Therefore, this disease can occur in any person.

Urethritis symptoms

Already at the very beginning of the disease, pronounced symptoms of urethritis appear: severe pain and sting, burning sensations and itching when urinating. Also, in the process of urination, a person may feel any other uncomfortable manifestations. Similar sensations arise in the genitals and in the perineum.

Another important symptom of urethritis is the appearance of discharge from the urethra. They can be varied in nature. So, depending on which pathogen provoked urethritis, the discharge is very abundant or very scarce. During an exacerbation of the disease, the edges of the external opening can 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 with each exacerbation become more pronounced. 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 severe burning and pain during urination, the presence of abundant discharge from the urethra, edema and noticeable reddening 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, there is a decrease in pain and swelling in the urethra, and the amount of discharge also decreases. Only in the morning does a crust sometimes appear, sticking together the external opening of the urethra. The urine has a transparent shade, purulent filaments can be found in it.

With chronic urethritis, which manifests itself as a result of an incorrect approach to treatment or the complete absence of such, neurotic phenomena are possible. Most often, with this form of urethritis, small ones are present. They become more abundant, subject to the presence of some factors that provoke an exacerbation of the disease. It can be heavy drinking, agitation, hypothermia. Symptoms of chronic urethritis are often similar to those of 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 the signs. It is important to take into account that in the absence of therapy, the symptoms of urethritis can 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 of urethritis.

Diagnostics of the 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 onset of urethritis in the patient. So, to establish the causative agent of the disease, various laboratory tests are used (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 certain therapy.

Urethritis treatment

In order for the treatment of urethritis to be as effective as possible, it is necessary, first of all, to determine which 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 medicines are used to combat pathogenic microorganisms. First of all, it is , as well as agents with antifungal and antiviral effects.

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

Both specific and nonspecific urethritis are treated according to 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 instillations of drugs into the bladder and urethra. The treatment process can last as long as 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 drug treatment is effective, but also compliance with the prescribed by the doctor , abstinence from alcohol, drinking plenty of fluids.

After the course of therapy is over, and all the symptoms of the disease have disappeared, it is imperative that tests be repeated to monitor the patient's condition. This will help ensure that the infection has been eradicated.

The doctors

Medicines

Prevention of urethritis

As a preventive measure for urethritis, it is important to adhere to a healthy diet, excluding an abundance of spicy, salty, sour foods, alcoholic beverages from the diet. The correct drinking regime is also important: every day a person should consume a sufficient amount of liquid. The best option is to use plain non-carbonated water. If necessary, diuretics can be used - for this, linden tea, cucumber, blackcurrant and cranberry juice, parsley are suitable.

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

Complications of urethritis

In the absence of the necessary treatment, urethritis in men can be complicated by a number of phenomena. First of all, acute urethritis can become chronic. The development of an inflammatory phenomenon of the prostate gland is possible ( prostatitis ), testicular inflammation ( orchitis ), the inflammatory process of the 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 violation of the microflora of the vagina , vinflammatory phenomena of the urinary tract .

List of sources

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